Advance Directives: Voicing Your Wishes

First published November 2016
Updated August 2026

Most people don’t think about medical decisions until a crisis happens, but by then it can feel overwhelming. As a member of our pediatric palliative care team, my job is to help provide an extra layer of support to patients and families facing serious, or potentially life-limiting, illness. Our goal is to maximize quality of life in the face of a sometimes uncertain journey and to ensure that a patient and their family’s goals and wishes are honored when making important medical decisions.

Let’s face it, life is unpredictable. In an era where there is so much medical technology available, the possibility of an immense family burden or poor quality of life may lead some to choose options other than life-support or aggressive resuscitative measures. One way to gain some control over an otherwise uncontrollable situation is to be prepared with the proper documents. Because of this, we recommend all adults complete their advance directives.

What Are Advance Directives?

Advance Directives are legal documents that give you the ability to express your wishes for medical treatment before the emotion and stress of a decision can cloud your judgment.

Advance Directives typically come in two forms:

1. Healthcare power of attorney (HPOA) documentation that allows you to select a person you trust to be your voice for healthcare decisions if you become unable to speak for yourself. In the event this occurs, this designated person then becomes your active health care agent. Your healthcare agent only steps in if you cannot make decisions for yourself, and their access to your information is limited to what is medically necessary at the time.
2. A Living will is a document that describes what types of medical treatments you would or would not want at end-of-life ONLY if you are faced with a terminal condition or are in a permanently unconscious state.

Conversations around advance directives aren’t just for older adults or those with chronic illness. For most, turning 18 is a milestone that means becoming your own medical decision-maker. Think about a young adult heading off to college – away from home, more independent, and often assuming “nothing will happen.” But if an unexpected illness or injury occurs, parents or loved ones may not legally be able to make the clear decisions or even access information without clear documentation. Having an advance directive or appointing a healthcare power of attorney ensures that, even in those rare but serious situations, your chosen healthcare agent can speak on your behalf and honor your wishes. These situations are scary enough for you and those you love, and these documents help ease some of the decision-making burden for everyone involved.

It is important to know that these documents can be modified at any time, and while each can be completed separately, we encourage a conversation about both so that loved ones can better understand your wishes and what is important to you when it comes to medical decisions. We have even encouraged adult members of a family to sit down together over a meal to have these discussions to promote closeness, trust, and understanding. These key conversations can ensure that your wishes guide important decisions. In our work, we have seen families feel relief in knowing exactly what their loved one wanted, and others struggle with regret – wishing they had known.

The best time to complete an advance directive is before an emergency arises, when everyone is of sound mind and calm demeanor. Advance directives are documents that people hope to never use but are always thankful to have in case they do.

Interested in Completing Your Advance Directive?

Each state has its own Advance Directive forms that can be filled out and notarized. State of Ohio documents can be downloaded and printed here. If you are a patient over the age of 18, we encourage you to contact your healthcare provider or social worker to get help in completing these forms. It’s not an easy conversation, but it’s one of the most meaningful gifts you can give the people who care most about you.