One of our basic rights is that of self-determination. Most of us, as a matter of course, accept and exercise our right to choose where we live, where we seek employment, with whom we spend our leisure time, etc. However, one very basic right of self-determination that is often left up to our loved ones in times of crisis without benefit of our input is the provision of medical treatment at the end-of-life. Another right we often don’t exercise is deciding who you want to make medical decisions for you during periods of mental incapacity. Thinking about one’s life ending or that of a loved one isn’t easy. Therefore, it is important to do so well ahead of such an emotion-filled time. If we do not provide any instructions, we leave our loved ones in a very difficult position. In addition to their sadness, our family now has to make treatment decisions without knowing what we wanted. It is much easier when a family can say, “I know this is what he [or she] wanted.”

For many years in health care, people have had the legal right to make their own decisions about accepting and/or refusing treatments offered by a physician. This is referred to as a right to self-determination, or autonomy. This right includes the time when end-of-life decisions are made. The most effective way of exercising this right is to complete an AD.

What is an AD?

An AD is basically a set of instructions. It is an opportunity to look ahead to a time when you are ill and not able to speak for yourself, but want your loved ones/significant others to understand what medical treatments you would or would not want. Your preferences may pertain to end-of-life issues or any other illness situations when you are incapacitated and unable to make decisions. An AD can be either oral or written according to current Florida Law, but recent events such as the Schiavo Case have demonstrated the advantages of having a written document.

Who should have an AD?

Any person who has the legal right to make decisions for him/herself should have an AD. This usually means all persons who are capacitated (alert, aware and able to understand and make health-related and other personal decisions) and at least at an age of maturity (adulthood).

Older teenagers who are able to consider and have opinions about these issues should also consider completing an AD. However, keep in mind that the Florida Law that speaks to these matters (Chapter 765) does not apply to minors.