The ‘living will’ was the first and best known advance directive. A living will is used to describe the kinds of medical or life-prolonging treatments you would want (or would not want) if you were seriously or terminally ill. But a key point here is that a living will does not allow you to select someone to make decisions for you.

Is there a problem with the living will?

Potential problems with living wills are that they are too vague, not used, or can be frustrated by someone else’s wishes. They are often too vague because the critical situation they are designed for is not as simple as you thought it would be… like being on a ventilator, permanently unconscious and never expecting to recover.

Most of the time, your situation is not so clear, but rather straddles a gray area. Such gray area situations are:

* You may be conscious, at least intermittently.

* You may have some cognitive and motor functions but not others, or

* Your situation simply does not have a clear prognosis.

Living wills are also not used because family members don’t know you made one, have forgotten about it, or can’t find it if they know you made one.

But even if family members have their living will, they may not agree with your wishes or tell the doctor what they, not you, would want done. Doctors concerned about lawsuits can wait if someone strongly objects to carrying out what they “interpret” as the patient’s living will.

To remedy these shortcomings, the next generation of advance directives called for you to add an ‘agent’ for you to express your wishes when you are unable to. These directives are

* health care proxy designation and

* medical power of attorney

Whoever you designate has the same rights to request or refuse treatment that you would have if you were still capable of making and communicating health care decisions. But there was still a problem with these; It was that the ‘manager’ was often not sure what he would want done in the given circumstance!

Therefore, a third generation of advance directives has been designed to include rich content taken from you while you are in good health to help you and your designated agents, family members, and physicians better understand and follow your wishes. The names of such advance directives are:

* History of values

*Medical Directive

* Directive of the Five Wishes

*Advance directives for life care

-What should you do?

Create both a living will and a health care power of attorney (or power of attorney). Choose well your appointee to carry out your wishes. But keep him aware of what he wants as time goes on.