What is an advanced health directive?
It is a legal document that outlines how a person wants to be treated in the potential end-of-life medical decisions. The directive has two primary components:
- Living will: includes types of treatments a person does or does not want
- Health Care Proxy/Power of Attorney: the person that will be responsible for any decisions that need to be made
In what situations do they come into effect?
The directive will come into effect if a person is in an accident or medical emergency, and he or she is unable to make decisions about their health, becomes incapacitated, fall into a coma, or must be kept alive by artificial life support.
What does this document stipulate?
If a person becomes incapacitated, their healthcare representative has to act in good faith and in their best interest, including acting in compliance with their religious faith. The directive will ensure their wishes are followed and it protects their family, so they don’t have to make these difficult decisions for their loved ones. It is very important to make one’s intentions known to everyone before one suffers a critical illness, disability, or incapacity. The health directive contains a person’s wishes and preferences about healthcare, including moral and religious values when it comes to end-of-life issues. With this directive in place, physicians and family are required to follow the outlined wishes.
What happens if you don’t have an advanced health directive?
If you don’t have a health care directive, your family is responsible for your health care decisions if you’re unable to make decisions for yourself. If your family does not agree on health care decisions for you, it can lead to litigation that seeks to have a court make the decisions for you.
Does a certain family member have more authority to make a decision versus another, in case there is no directive in place?
If there is no advanced directive in place, then the authority to make the decisions can vary by state. Most states will default to “surrogate consent laws” or “family consent laws.” These laws provide some guidance on the hierarchy of authorized decision-makers. Generally, in order of priority, it is:
- Spouse (unless divorced or legally separated)
- Adult child
- Parent
- Adult sibling
Some states also include designations for other adult relatives including grandchildren, nieces and nephews, aunts and uncles, any living adult relative, and “close friend.”
Where should you keep your directive?
The following is an excerpt from Harvard Health Publishing at the Harvard Medical School on who they recommend should have access to your advanced health directive:
Here are some people who should have copies of your advance directives and some other places where they should be filed.
- Your health care agent and any alternative agents. All should have a copy of your health care power of attorney (and your living will, if you have one). In an emergency, your agent may need to send the documents to doctors or a hospital.
- Your doctor. A copy of your advance directives should be in your file and medical record.
- Your hospital chart. If you are in the hospital, ask to have a copy of your advance directives put in your chart. (Your health care agent or a family member should do so if you are unable to do it.)
- A safe spot in your home. File the original documents in a secure place in your home — and tell your agent, family, and friends where you put them. Hospitals may request an original, so it’s important that someone can find the documents when necessary. The National Hospice and Palliative Care Organization suggests noting on all copies of the documents where the originals are stored.
- Carry it with you. Put a card with your health care agent’s name and contact information in your wallet or purse. Also, note on the card where you keep the original and additional copies of your directives.
Is there an advanced health directive template?
Many states provide forms, and in some cases, there are universal templates that are accepted across multiple states. Also, important to note, that the living will and health care proxy forms may be separate documents in some states.
What can I stipulate in my directive to be in compliance with the sharia?
Here are a few resources that provide some guidelines on creating a directive in line with the principles of sharia. It is recommended that you consult with a scholar, medical professional, and attorney to ensure the specifics of your situation are effectively covered by any such directive.
- IMANA: Medical Ethics Booklet (Page 14: Sample Advance Health Directive Template)
- ShariaWiz provides an advanced health directive product that meets the legal requirements of your state
- Yaqeen Institute: Pulling the Plug: The Islamic Perspectives on End-of-Life Care
- Fiqh Council of North America: Moral Status of Organ Donation and Transplantation
