New York incapacity planning: Understanding advance care directives

Understanding and establishing advance care directives may help New Yorkers of all ages protect their best interests and wishes in the event of incapacity.

Sudden accidents, serious illnesses, unexpected issues during medical procedures and numerous other situations may leave people who are otherwise young and healthy unable to speak or care for themselves. In the state of New York, unless they have taken steps to prepare for such occurrences, their wishes may not be expressed and the decisions regarding their care may be left solely to the discretion of the overseeing health care professionals. Therefore, it behooves people of all ages to understand the importance of establishing advance care directives.

Advance care directives are legal documents used to specify people's wishes regarding their medical treatment and care, as well as to designate someone to speak on their behalf should they be unable to make decisions for themselves. There are three types of advance care directives recognized in the state of New York - the do not resuscitate order, the living will and the health care proxy.

What is a do not resuscitate order?

In emergency situations, there is a range of life-saving treatments that medical professionals may administer. This includes mechanical interventions and cardiopulmonary resuscitation. Due to personal preferences, religious beliefs or other factors, some people may prefer not to receive certain treatments. Do not resuscitate orders, or DNRs, are medical orders that people establish with their health care providers prior to emergency situations. These legally binding documents instruct medical providers not to perform the specified procedures in the event people's hearts stop beating or they stop breathing.

What is a living will?

In addition to medical treatments, there are numerous other decisions that must be made when people become incapacitated. Where will they live? Who will provide their day-to-day care? Do they have any religious beliefs that may affect their treatment or care?

Living wills are written declarations of people's wishes regarding such decisions. Through such documents, people can clarify their values and beliefs. They can indicate the types of treatments they would want, as well as the situations in which they would accept or refuse medical care. Unlike traditional wills, which go into effect upon people's deaths, living wills become effective only should people become unable to speak for themselves.

What is a health care proxy?


Should they be left comatose or otherwise unable to speak for themselves, people may not be able to express their wishes or make decisions for themselves. A health care proxy is a form that allows people to appoint a trusted friend or family member to act on their behalf in such cases. In order for a health care proxy to take effect, two medical professionals must determine that a person cannot make his or her own decisions.

When it comes to specifying their wishes to their named agents, people may express them orally or in writing. Through the health care proxy, they may grant their agents as much or as little decision-making authority as they are comfortable with. Those named as agents are required to make decisions that are in the proxy holder's best interests and that are in accordance with his or her wishes and moral beliefs.

Working with an attorney

Thought of by many in New York and elsewhere as steps only necessary for the elderly, establishing advance care directives is an important step for people over the age of 18-years-old. Consulting with an attorney may help people understand how these documents can help protect them and their wishes in the event of incapacity. A legal representative may also guide them through the process of drawing up advance care directives that are legally sound.