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Advance
Directives
Available
here is a new, more user-friendly advance
directive form and instructions. The form may now be
filled out on your computer and printed. You can use it
to make health care choices. If you prefer, we'll mail
you
one
copy.
E-mail
your request for a printed copy to adforms@oag.state.md.us,
call 410-576-7000, or write to Attorney
General's Office, Health Decisions Policy Division, 200 St. Paul
Place, Baltimore, MD 21202. This is a free service, limited
to one copy only, but you are welcome to make as many copies
yourself
as you want.
Advance Directive for the Visually Impaired
The
Montgomery County Coalition on End-of-Life Care offers versions
of the Maryland advance directive form in the following languages:
Spanish, Chinese, French, Korean, Russian, and Vietnamese. These
materials are available here.
This
form is optional. No one is required to fill it out, and
other forms may be used and are just as valid legally. For example,
a widely praised form called "Five Wishes" is available (for
a small fee) from the non-profit organization Aging
With Dignity. Advance directives from a variety of religious
perspectives are available here.
You
can download
the State's "Advance Directive Information Sheet", printer-friendly
information on advance directives, here. (PDF)
To get information about a Physician's Order
form that allows emergency medical personnel to provide comfort
care instead of aggressive interventions (an "EMS/DNR Order"),
call the Maryland Institute for Emergency Medical Services
Systems at (410) 706-4367. You can also download the EMS/DNR
Order at: http://www.miemss.org
The Maryland
Department of Health and Mental Hygiene makes available
an advance directive focused on preferences about mental health
treatment.
Wallet Cards
If
you've made an advance directive, you should consider carrying
a wallet card
saying so. The
Attorney General's Office has developed a wallet
card for your
use. This card alerts healthcare workers that you have an advance
directive and provides contact names and numbers. Simply print,
then fill out the card and carry it in your wallet. Click
here for the card.
As
a public service, the American Hospital Association also makes
a wallet card available through a website called "Put
It In Writing."
What
You Should Know About Advance Directives
 Everyone
has the right to make personal decisions about health care.
Doctors ask whether you will accept a treatment by discussing
the risks and benefits and working with you to decide. But what
if you can no longer make your own decisions? Anyone can wind
up hurt or sick and unable to make decisions about medical treatments.
An advance directive speaks for you if you are unable to and
helps make sure your religious and personal beliefs will be respected.
It is a useful legal document for an adult of any age to plan
for future health care needs. While no one is required to have
an advance directive, it is smart to think ahead and make a plan
now. If you don’t have
an advance directive and later you can’t speak for yourself,
then usually your next of kin will make health care decisions
for you. But even if you want
your next of kin to make decisions for you, an advance directive
can make things easier for your loved ones by helping to prevent
misunderstandings or arguments about your care.
What can you do in an advance directive?
An advance
directive allows you to decide who you want to make health
care decisions for you if you are unable to do so yourself.
You can also use it to say what kinds of treatments you do or
do not want, especially the treatments often used in a medical
emergency or near the end of a person’s life.
1.
Health Care Agent. Someone you name to make decisions about your health
care is called a “health care agent” (sometimes
also called a “durable power of attorney for health care,” but,
unlike other powers of attorney, this is not about money). You
can name a family member or someone else. This person has the
authority to see that doctors and other health care providers
give you the type of care you want, and that they do not give
you treatment against your wishes. Pick someone you trust to
make these kinds of serious decisions and talk to this person,
to make sure he or she understands and is willing to accept this
responsibility.
2.
Health Care Instructions. You can let providers know what treatments
you want to have or not to have. (Sometimes this is
called a “living will,” but it has nothing to do
with an ordinary will about property.) Examples of the types
of treatment you might decide about are:
a. Life
support – such as breathing with a ventilator
b. Efforts to revive a stopped heart or breathing (CPR)
c. Feeding through tubes inserted into the body
d. Medicine for pain relief
Ask your doctor for more information about these treatments.
Think about how, if you become badly injured or seriously ill,
treatments like these fit in with your goals, beliefs, and values.
How
do you prepare an advance directive?
 Begin
by talking things over, if you want, with family members, close
friends, your doctor, or a religious advisor. Many people
go to a lawyer to have an advance directive prepared. You can
also get sample forms yourself from many places, including the
ones given as examples at the end of this information sheet.
There is no one form that must be used. You can even make up
your own advance directive document.
To make your advance directive valid, it must be signed by you
in the presence of two witnesses, who will also sign. If you
name a health care agent, make sure that person is not a witness.
Maryland law does not require the document to be notarized. You
should give a copy of your advance directive to your doctor,
who will keep it in your medical file, and to others you trust
to have it available when needed. Copies are just as valid as
the originals.
You can also make a valid advance directive by talking to your
doctor in front of a witness.
When would your advance directive take effect?
 Usually, your advance directive would take effect when your
doctor certifies in writing that you are not capable of making
a decision about your care. If your advance directive contains
health care instructions, they will take effect depending on
your medical condition at the time. If you name a health care
agent, you should make clear in the advance directive when you
want the agent to be able to make decisions for you.
Can you change your advance directive?
Yes, you can change or take back your advance directive at any
time. The most recent one will count.
Where can you get forms and more information about advance directives?
There
are many places to get forms, including medical, religious,
aging assistance, and legal organizations. Three places are shown
below, but these are just examples. Any of these forms are valid
in Maryland, but not all may be in keeping with your beliefs
and values. Your advance directive does not have to be on any
particular form.
The Attorney General's Office has created an informational presentation
on advance care planning and advance directives:
The Maryland Attorney General’s Office
410-576-7000 or 1-888-743-0023.
Click here to download the form
www.oag.state.md.us/healthpol/adirective.pdf
Caring
Connections (NHPCO)
1-800-658-8898
www.caringinfo.org
Aging with Dignity
1-888-594-7437
www.agingwithdignity.org
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