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or radiation, and life-prolonging procedures, such as CPR, respirators, antibiotics, feeding or hydration tubes, and dialysis, none of which are expected to cure a terminal condition.
2. As you begin the process, think about your beliefs, values, and life goals. You may have some experience with family or friends who were unable to communicate their treatment choices. What was that like for the others involved? What issues arose? If you have concerns of a spiritual, ethical, or emotional nature but do not have someone in the clergy to talk to about them, call the Hospice chaplain. You should also think carefully on your designation of a primary and substitute proxy (also called' an “agent” or “medical power of attorney for health care”), the person who will speak for you if you cannot, who would be best at making sure your wishes are followed even if he or she would not make the same choices personally.
This may or may not be the same person to whom you choose to give durable power of attorney for handling financial issues in the case of your death; in fact, you or your proxy may specifically not want to be responsible for both financial and medical matters, to avoid potential “conflict of interest” accusations.
3. Write down your plan. National organizations specializing in end-of-life care have produced tools to help you decide what you want and don’t want, including Five Wishes (www.agingwithdignity.org), Caring Conversations (www.midbio.org), and Let’s Start Talking (www.nhpco.org).
Complete and sign an Advance Medical Directive form, and have two witnesses sign it. In most states (including Virginia), it does not need to be notarized or have an attorney’s participation. And remember, your advance directive only goes into effect if you are unable to communicate, and can be rescinded or modified by you at any time.
4. Discuss your wishes with your family members, especially those who might disagree with each other— or with you — about your preferences. As William Colby, the lawyer who represented
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