An advance directive — also called a living will, advance decision or advance care plan — is a legal document that records your healthcare preferences for situations in which you're unable to communicate them yourself. It's one of the most important but least-discussed aspects of adult health planning.
What advance directives cover
- Resuscitation preferences — whether you wish CPR to be attempted if your heart stops
- Life-sustaining treatment — mechanical ventilation, dialysis or artificial nutrition in terminal illness
- Organ donation — whether you consent to organ donation and which organs
- Mental health treatment — what interventions you do or don't want if you lose mental capacity
- Preferred place of care and death — home, hospice or hospital
- Designation of a healthcare proxy — someone who can make decisions on your behalf
Why you should have one — at any age
Advance directives are commonly associated with old age or terminal illness, but accidents and sudden illness can affect anyone at any age. A young adult in an intensive care unit is just as likely to need someone to make decisions on their behalf as an elderly person with dementia.
Without a directive, decisions fall to next of kin — who may not know your wishes, may disagree with each other or may not be legally empowered to make certain decisions. A clear, legally valid directive removes that burden and ensures your values guide your care.
"The best time to write an advance directive is when you're healthy and clear-headed, not when a decision needs to be made immediately."
Sara Nassereddin, Health Technology Writer
How to create one
Requirements vary by country. In most jurisdictions, you need to be an adult of sound mind, sign the document in front of witnesses, and in some places have it notarised. Your GP can guide you, and many countries have government-approved templates. Store copies with your GP, hospital, a family member you trust, and in your digital health record.