Planning for Uncertainty: A Guide to Living Wills and Other Advance Directives for Health Care

Most of us are uncomfortable with thoughts of our own death or serious illness and so we put off decisions we ought to make when we're healthy, when we can spend time thinking about our values and preferences. Planning for Uncertainty tells you why it is important to think carefully about the final details of your life and to plan for the possibility that you won't be able to make your wishes known. As family physicians, the authors of Planning for Uncertainty have seen what happens when a person lacks any kind of advance directive for health care, becomes seriously ill or injured, and loses the capacity to express preferences and make decisions about health care. The result can be great anguish for families and needless suffering for patients.

Planning for Uncertainty uses a question-and-answer format to explain what you need to know about advance directives the living will, the durable power of attorney, and the values history. All are intended to clearly document your preferences and decisions about life-sustaining health care, a practice strongly encouraged by the Patient Self-Determination Act of 1990. The authors explain a broad range of medical choices, tell why and how to prepare advance directives, and explore ethical issues such as active euthanasia, assisted suicide, and passive euthanasia. Topics include

• The types and purposes of advance directives for health care

• The provisions of the Patient Self-Determination Act

• Deciding when medical treatment is beneficial and when is it futile

• How ethical principles affect health care decisions

• The legal significance of the living will and the durable power of attorney for health care

• Writing a "Values History" to outline your health care preferences

• Involving your family, your physician, and others

With sample documents and a wealth of practical information, Planning for Uncertainty enables you to prepare for the possibility that some day you may be unable to communicate your health care decisions. It allows you to spare your family the difficult task of deciding for you and to spare yourself from futile medical procedures. Here is a comprehensive and reliable resource for everyone who wants to learn more about advance directives, including health care professionals, retirement counselors, and family legal advisers.

David John Doukas, M.D., is assistant professor in the department of family practice at the University of Michigan Medical School and chair of the ethics committee at the Chelsea Community Hospital in Chelsea, Michigan. William Reichel, M.D., is director of the department of geriatrics and aging services at Boston Evening Medical Center, clinical professor of community health at Tufts University School of Medicine, and adjunct professor of family medicine at Brown University.