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Informed decision

When you can’t speak for yourself, Advance Care Planning does the talking.

Article Author: Johnny Woodhouse

Article Date:

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People with a serious illness or injury face complex choices that have important and lasting consequences, not just for themselves, but for loved ones, as well. Thinking and talking about these difficult decisions with family members and health care professionals is called Advance Care Planning (ACP).

Knowing a person’s medical preferences can help prevent a decision-making crisis down the road.

“ACP is the ongoing deliberation, discussion and documentation of goals for care,” said Elizabeth McCullough, MD, an internal medicine and Palliative Care specialist at Baptist Health. “It’s not a conversation about dying. It’s about maintaining control when faced with a medical catastrophe and determining how to protect those we love by giving them guidance.”

Two documents to consider

Advance directives are sets of documents that help define how you want to be cared for and who will act as your medical decision-maker(s) in the event you’re unable to speak for yourself. These may include:

  1. Health care surrogate: Informs medical professionals who to talk to if they need help making critical decisions about your care and can’t speak with you. A health care surrogate makes choices about your treatment plan based on your values and beliefs. They only act if you are unable or choose not to make those decisions for yourself.
  2. Living will: Written documentation of your values and care preferences. This document should be reviewed and updated regularly, especially following a change in diagnosis or prognosis, a divorce or the death of a loved one.

A living will can ease the stress of important decision-making by helping loved ones better understand your values as they relate to medical care.

Surrogate responsibilities

Assigning a health care surrogate who you know and trust to carry out your wishes is critically important.

This can be any competent person of your choice over the age of 18, including a relative, friend or member of your faith community. Ask that person whether he or she agrees to act for you before your complete an advance directive. It’s important to note that your surrogate’s obligation is to make decisions based on your beliefs, not his or her own.

There are no financial obligations to serving as a health care surrogate.

'ACP is not foolproof’

Adults are encouraged to assign a health care surrogate and start having conversations about their medical preferences as early as 18, but desires for critical or advanced care can be difficult to define when someone is healthy.

“ACP is not foolproof. It’s a living document that will change as we do. It can’t predict every circumstance,” said Dr. McCullough. “That’s why we advise everyone to begin to think about and discuss their goals of care when they feel comfortable doing so. When you feel confident in your medical decisions and wishes, it’s time to complete a living will to document those preferences.”

Cynthia Anderson, MD, a radiation oncologist at Baptist MD Anderson Cancer Center, filled out her own advance directives when she was in medical school and now guides others through the process as a physician.

“I have these important conversations regularly with my patients and their families and I can see the difference in their stress level when they have these documents done,” Dr. Anderson said.

Dr. McCullough added, “Sharing your preferences with loved ones and providers is the goal of ACP. In the face of future medical crisis, ACP can be the power to ease suffering.”


Baptist Health offers a free, online class on Advance Care Planning twice a month. To sign up or find resources and guides to get started on your own planning, visit baptistjax.com/conversation.

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