Medical directives help guide care Published April 15, 2009 By Capt. ALLISON MAIMONA 56th Fighter Wing Staff Judge Advocate LUKE AIR FORCE BASE, Ariz. -- The second annual National Healthcare Decisions Day was Thursday and was ment to raise awareness of the need for adults to discuss and document personal healthcare decisions before they become ill or unable to communicate those wishes. Making healthcare decisions can be stressful under the best of circumstances, but what if a person is incapable of communicating those medical wishes? Who should make the decision for a person to be kept alive via a ventilator or artificial nutrition and hydration? In 1990, the United States Supreme Court found in the case of Cruzan v. Director, Missouri Department of Health that states could require "clear and convincing" evidence of a patient's wishes in order to remove life support. Advance medical directives, such as healthcare powers-of-attorney and living wills can be crucial in establishing such evidence of the person's wishes. A healthcare power of attorney is a tool an individual uses to express in writing specific medical treatment decisions that will guide the attending physician should the person become incapacitated, and to name an agent who will make choices about treatment decisions when the person's wishes are unknown. A living will stipulates the kind of life-prolonging medical care desired if that person becomes terminally ill, permanently comatose, or in a vegetative state and unable to make medical decisions. Advanced medical directives are not just for the elderly. In fact, the stakes may be higher for younger adults that, if tragedy were to strike, could be kept alive for decades in a condition they would not have wanted. Some of the most well known cases include Terry Schiavo, Nancy Cruzan and Karen Ann Quinlan who were all in their 20s. Before having an advance directive drafted, members should think about and discuss preferences with family and friends. Considerations may include views on death, being totally dependent on the care of others, the role of family finances, conditions that would make living personally intolerable, and how artificial life support would affect the dying process. Other resources that may be helpful in thinking about medical choices and end-of-life planning include the elder law hotline at (800) 231-5441 and www.nationalhealthcaredecisionsday.org. The 56th Fighter Wing Staff Judge Advocate legal office drafts advanced medical directives for servicemembers during the following walk-in legal assistance hours: 9 to 10 a.m. Mondays; 8 to 9 a.m. Tuesdays and Thursdays; and 2 to 4 p.m. Wednesdays. For more information, call (623) 856-6901.