Harvard University Health Services

Advance Directive

The Federal Self Determination Act and the Massachusetts Health Care Proxy Law both support the right of all competent adults, age 18 or older, to make their own health care decisions as to what medical care or treatments to accept, reject, or discontinue. The law protects the right to self-determination about future health care through its recognition of Advance Directives.

What is an Advance Directive?
  • The term Advance Directive refers to a document that you create and sign while you are mentally competent to state your wishes for treatment and becomes effective when you are no longer able to make or communicate you own health care decisions. There are two components that make up an Advance Directive:
  •  A Health Care Proxy, sometimes referred to as a Durable Power for Health Care, identifies another person to make medical decisions on your behalf with your physician should you become unable to make or communicate such decisions on your own. The Health Care Proxy is authorized by statute in Massachusetts. If you decide to designate a proxy (usually a family member or trusted friend), you should share your thoughts and beliefs regarding medical treatment with that person so that he or she will be best able to carry out your wishes.
  • A Living Will provides specific instructions regarding your wishes for your future medical care. Such a document should be developed following discussion with your physician. It then becomes part of your medical record.
  • We encourage all patients, regardless of current age or health status, to consider the creation of both these documents.
Why consider an Advance Directive?
Today's highly sophisticated medical knowledge has made possible enormous strides in treating very serious illnesses and injuries. Because these technological advances may not always cure a particular condition or disease, it is important to consider the kind of treatment you would want for yourself under various circumstances and to make your wishes known to your physicians, ahead of time, using an Advance Directive.

How do you establish an Advance Directive?
Your Advance Directive will be valid if, while you are competent, you fill out and sign it before two qualified adult witnesses. Understanding your preferences will help your physician carry out your choices. Remember, that while you can and should discuss your health care with your family and your physician, decisions about your medical treatment are ultimately your own.

Where is the form kept?
A copy of the completed Advance Directive is kept with your medical record. A copy should also remain with your accessible important papers, and you should give copies to relevant people, such as your family members, your health care proxy and your lawyer.

Can you change your mind regarding your Advance Directive?
Advance Directives go into effect only when you can no longer make or communicate your own medical decisions. Therefore, you can change your Advance Directive at any time beforehand, by completing a new form stating your wishes and signing and dating that form before two qualified adult witnesses. Be sure that you retrieve the old advance directive, destroy it, and replace it with the updated one.

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Disclaimer: The information provided on our website is not intended to diagnose or treat any health problem or disease. It is meant to support, not replace, the relationship that exists between an individual and his/her clinician.