An advance directive is a legal document that you can complete on your own that can help ensure your preferences for various medical treatments are followed if you become unable to make your own health care decisions. Your advance directive only goes into effect if your physician has evaluated you and determined that you are unable to understand your diagnosis, treatment options or the possible benefits and harms of the treatment options.
New Jersey has two kinds of advance directives, a “proxy directive” and an “instruction directive.” It is your decision whether to have both kinds or to just have one of them.
(Durable Power of Attorney for Health Care, sometimes called Health Care agent, surrogate or representative)
A proxy directive is a document you use to appoint a person to make health care decisions for you in the event you become unable to make them yourself. This document goes into effect whether your inability to make health care decisions is temporary because of an accident or permanent because of a disease. The person that you appoint is known as your “health care representative" and they are responsible for making the same decisions you would have made under the circumstances. If they are unable to determine what you would want in a specific situation they are to base their decision on what they think is in your best interest.
An instruction directive is a document you use to tell your physician and family about the kinds of situations you would want or not want to have life-sustaining treatment in the event you are unable to make your own healthcare decisions. You can also include a description of your beliefs, values, and general care and treatment preferences. This will guide your physician and family when they have to make healthcare decisions for you in situations not specifically covered by your advance directive.
The state of New Jersey mandates that all adult patients admitted to the hospital be asked if they have an advance directive. If you have already prepared such a document, please be sure to bring a copy to the hospital upon your admission or have someone bring in a copy to be placed in your medical record. Your advance directive must be signed and dated by you in the presence of two witnesses or a notary public. You have the right to revoke or revise your directive at any time by notifying, orally or in writing, your health care representative, physician, nurse or other health care professional or reliable witness.
What Matters to You
You have the right to accept or refuse any appropriate medical treatment such as surgery, chemotherapy, blood transfusions, medications or other treatments aimed at supporting your organs which may prolong your life. These end-of-life treatments may include the use of an artificial breathing or kidney machine, cardiopulmonary resuscitation (CPR) and artificial nutrition or hydration. An advance directive usually includes your preferences about these treatments and the conditions under which you would or would not want them.
Comfort measures, such as pain/symptom management and social and spiritual support are always provided with respectful and dignified care regardless of your preferences for other treatment.
You should discuss your advance directive with the important people in your life before a medical crisis. Keep the original in a place known to others and provide a copy to your proxy. You may also choose to give a copy to your physician and clergy. More information about advance directives may be obtained by calling the Atlantic Health System’s patient representative or social work services at your hospital.
Atlantic Health System will not discriminate against anyone based on whether or not that person has an advance directive and will continue to provide appropriate care based on the treatment plan decided upon by you, your loved ones and your physician to best meet your needs.
Resources for Advance Directives and Health Care Proxy
- New Jersey Department of Health – Advance Directive
- Atlantic Health System Advance Directive
- New Jersey Advance Directive and Proxy Directive (care of National Hospice and Palliative Care Organization)
- Prepare for your Care
- Join Cake
- Five Wishes
- The Conversation Project