Advance directives: Wills about end-of-life care

Advance directives allow you to make known in advance your wishes on your end of life in case you can't no more showing your will. For example, after coma, after profound cognitive impairment, after an accident, because of the course of an illness, or because of old age.

The guidelines are not intended to be used if you are able to express your wishes.

These guidelines express your will on the conditions of pursuit, of the limitation, of thestoppage or the refusal of treatment or medical procedures.

Advance directives should take the form of a written, dated and signed document with:

• Your first and last names
• Your date and place of birth.

The document is handwritten or typed.

Some health care facilities provide a form.

To help you, 2 templates with editable fields are proposed, depending on whether you are currently well or have a serious illness.

The use of this model is not mandatory. Advance directives can also be written on free paper.

However, this model ensures that the expression of your will meets the conditions of validity provided by the regulations.

Model Advance Directives (preparation, amendment, cancelation)

Your attending physician should inform you of the possibility and conditions of writing advance directives.

Faced with a patient who is no longer able to express his wishes, the doctors must find out whether he has written advance directives.

So he's important that they are easily accessible.

Inform your doctor and family

You must tell your doctor and family :

• From theexistence of your advance directives
• And their place of conservation.

So, when the day comes, the doctor who will accompany you at the end of your life will know where to find your instructions to implement.

Take your instructions to the hospital or seniors' facility

If you are hospitalized for a serious illness or admitted to a seniors facility, you can refer your instructions to that hospital or facility.

He'll put them in your file.

Leave your instructions with a loved one

Finally, you can also entrust your instructions to:

• Your trusted person
• Someone from your family
• A relative.

Keep the guidelines at home

You can also store them at home and/or carry an indication of where they are stored.

Save directives in My health space and/or refer them to your doctor

It's yours recommended :

• To have your advance directives registered in My health space (shared medical record)

• And to inform your relatives (the person you trust or the 2 witnesses if you cannot write your instructions) that their names and personal details are recorded.

Also, if the shared medical record states that someone has your advance directives, be sure to inform them that their names and contact information are on it.

They will be easily accessible if necessary.

You can entrust your advance directives to your doctor who will keep them in the file he has compiled on your behalf, especially in the absence of a shared medical file.

Directives are imposed on the doctor for any decision on investigation, intervention or treatment.

However, they are not necessary in the following 2 cases:

• In a life-threatening emergency for as long as is necessary for a full assessment of the situation (for example, resuscitation after a sudden health event)
• Where advance directives appear manifestly inappropriate or not in accordance with the medical situation.
  In this case, the doctor must make his decision through a collegial procedure. This decision is therefore made by several doctors who discuss the case. Once that decision is made, it's in the medical file.
  The decision refusing to apply the advance directives shall be notified to the trusted person or, if not, family or loved ones.

Advance directives have a duration unlimited.

Advance directives can be at any time modified or canceled.

The last page of the model of advance directives is devoted to the modification or cancelation of directives:

Model Advance Directives (preparation, amendment, cancelation)

If you wish modify your advance directives, you can write new ones.

Then ask your doctor, hospital or healthcare institution that stores them to delete the previous ones.

If they have been saved to your shared medical record (digital health space), you can save new files.

Only the most recent document will be considered.