Let’s talk about the part of the advance directive that people rush through, even though it is the most important part: choosing your healthcare agent. This is the person who will speak for you when you can’t speak for yourself or when you choose to allow them to make decisions for you.

Hear me clearly when I say this: “If you are able to speak and want to speak on your own behalf, then the person you chose cannot speak for you.” 

This advance directive covers two primary situations: 1) a permanent state of unconsciousness (brain dead), or 2) terminal illness that will result in death soon, when you cannot communicate at all.

When your advance directive is activated, your healthcare agent steps in and makes medical decisions based on your wishes. They can consent to treatments, access your medical records, and be right there with you in emergencies—ambulance rides, hospital transfers, all of it.

So let’s be clear about what this is and what it isn’t. Being a healthcare agent does not mean they are responsible for your medical bills, it does not mean they can override your wishes while you are able to speak on your own behalf, and it does not mean they get to do what they want. Their role is simple, but not easy, because they are there to carry out what you have already decided.

Now here’s the part people don’t like to hear: this decision is not about who loves you the most. It is about who will follow your instructions even when they disagree with your wishes, because everything sounds simple until you’re in one of those conditions, and the medical team finds out if you chose right with your healthcare agent selection.

I’ve seen it. What people say they would do changes when they’re actually standing there looking at someone they love. Yes, your healthcare agent can override your decision, even if it is clearly written on paper, because you have given them the power to choose.

Look at the words on the form. It is called treatment preference. Preference is what you would like to happen, not what you are mandating to happen. There is a form a person can fill out that makes your choice a medical order that cannot be overwritten unless you change it yourself, but that form will be discussed in another post.

That is why you have to choose wisely, not based on who you think “should” do it, but based on who can stay grounded, listen to what you said, and carry it out even when it’s hard or when they disagree with you.

Sometimes that’s a spouse. Sometimes it isn’t. Sometimes it’s a friend. Sometimes it is a neighbor. Sometimes it’s not your children, and that’s okay.

I have chosen two chaplains to make decisions for me because they know firsthand what each of these conditions looks like, know what I would want, and are willing participants in carrying out my wishes.

If the person you choose can’t do it, they can step down, and if decisions aren’t being made appropriately, the court can step in. But every adult should have one regardless of age.
So here’s the question you need to answer: Who will follow my wishes—not their feelings?

Take a few minutes to think about that, and if you’re not sure, I’ve created a quick survey to help you walk through this decision and choose the right person without emotions getting in the way.
I’m challenging you to live prepared—just in case it rains.