Advance Care Planning

Many of us are uncomfortable talking about death and other end-of-life topics.  Unfortunately, advance directives often fall into this category of taboo subjects.  An advance directive is a legal document that dictates preferences about being kept alive by extraordinary medical effort when suffering from a terminal illness or severe disability.  While many people have strong opinions about whether they would like to be kept alive by artificial means, few actually take the steps to ensure that their wishes are honored.

A 2003 study by the Agency for Healthcare Research and Quality (AHRQ) found that 72% of respondents would refuse to be kept alive by resusitation or artificial nutrition if they had dementia or a terminal illness ¹.  The same study found that only 50% of terminally ill patients execute advance directives ².  The simple fact is that there are several easily completed documents that will allow loved ones to understand a patient's wishes regarding end-of-life care, even if the patient is not able to verbally express those views him/herself. 

Advance Directive Documents

Health Care Power of Attorney
This document allows a person to name someone to make healthcare decisions for them, should the person be unable to communicate their wishes.  Click on the link to view and/or download a Health Care Power of Attorney document.  This document is available in our Resource Library.

Advance Directive for a Natural Death (Living Will)
This document should be used as instructions for the future for anyone who would like their healthcare providers to withhold or withdraw life-prolonging measures in certain situations.  There is no legal requirement that anyone execute a living will.  Click on the link to view and/or download a Living Will.  This document is available in our Resource Library. 

Medical Orders for Scope of Treatment (MOST)
The MOST form is a physician's or medical order that describes a patient's end-of-life plan of care.  It is intended for patients experiencing a terminal illness with a prognosis of less than one year.  Since it is a medical order, any physician in any setting can follow the orders.  It is also bright pink so that it can be easily identified.  Click on the link to view or download a Frequently Asked Questions document as well as a sample of the MOST document.  These documents are also available in our Resource Library. 

Additional Resources

Please visit the following Web sites for more information about end-of-life planning:

National Hospice and Palliative Care Organization Caring Connections
Carolinas Center for Hospice & End of Life Care
North Carolina Medical Society--End of Life Resources
North Carolina Department of the Secretary of State -- Advance Healthcare Directive Registry





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^{1, 2}  Burgess, Kenneth L., "North Carolina General Assembly Overhauls Advance Directives Laws".  Mr. Burgess is a health care attorney in the Raleigh office of Poyner & Spruill LLP.