The Difference Between Advance Directives and Living Wills

If I have an Advance Directive (living will), do I also need a Healthcare Proxy and a Power of Attorney?

Ideally, everyone should have an Advance Directive (Living Will), a Healthcare Proxy, and a Durable Power of Attorney [POA].  Why?


I was asked to see a dying man who had an aggressive cancer and after surgery wasn’t able to breathe satisfactorily, ending up on a ventilator; his prognosis was very poor.  He had remarried after the death of his first wife and his children from his first marriage were upset with the decision made by their step-mom to stop the ventilator.  The doctors were uncomfortable stopping it due to this conflict,  which led to his being kept on the machine and prolonging his dying.

If he had a Living Will stating he didn’t want to be kept on a machine in this situation, and if someone (usually the spouse) had been appointed as his proxy or his POA to carry out his wishes, then it could have been made clear to the kids what their dad didn’t want and that his proxy had the authority to stop the ventilator and let him die peacefully.  Families usually are more accepting in the face of such legal documents.

An Advance Directive is a form you complete, explaining what treatments you want in the event you are unable to make decisions – for example, if you had a stroke and couldn’t talk, or were on a ventilator.  It is activated only when you cannot communicate effectively yourself.

A healthcare proxy is someone you appoint to make decisions only about your healthcare [it has nothing to do with your money]; it too is active only when you are unable to answer for yourself.

A POA is someone you appoint to make decisions for you at any time, regardless of your ability to make decisions.  However, POA may be limited to only financial or only health matters. 

Generally, it’s better to have your lawyer draft these documents to ensure you are getting what you want; but many people have used the Advance Directive forms from the State which only require signatures of two witnesses.

The bottom line is that everyone needs at least an Advance Directive with a Proxy [usually included on the Directive form]; however, a POA can be helpful depending on your circumstances.