Document your health
wishes and goals early
According to the recommendation from smarter medicine / Choosing Wisely, you should discuss your health goals and wishes early on with your care team and your loved ones. This helps ensure that you are offered treatments that align with your preferences and helps in the process of setting up an advance directive. Find out what this means for you and why it concerns everyone.
There is no
ideal time
It is never too early nor too late to think about your wishes and goals. You never know when fate may strike and you become unable to make decisions unexpectedly. This can happen regardless of age and health condition. After talking to your loved ones and your primary care provider, you should put your thoughts in writing to prevent unnecessary doubts in extreme situations.
Advance directive: Put wishes
into words
An advance directive expresses your wishes regarding medical treatments. You can appoint a healthcare proxy to make decisions on your behalf. Your advance directive only comes into effect if you become incapable of making decisions due to an illness or an accident and can no longer communicate your wishes to the medical team. An advance directive can be updated at any time.
Who is consulted first to make medical decisions
if I am incapable
of doing so myself?
Tap an answer to see the solution immediately.
Spouse or registered partner (provided you live in the same household)
Person living in the same household
Healthcare proxy named in the advance directive
The healthcare proxy named in your advance directive is consulted first. If no proxy is appointed, you can find out which person is consulted next in the FAQs.
Family members (1. children, 2. parents, 3. siblings)
Legal guardian with authority over medical decisions
After being diagnosed with heart failure, I created an advance directive. Therefore, I was resuscitated when I had a cardiac arrest and survived but remained weak and never fully recovered. For this reason I adapted my directive. I no longer want to be resuscitated or ventilated. Quality of life is more important to me than quantity.
What are
intensive medical interventions?
Intensive medical interventions are used to support or replace organ functions. Examples include resuscitation, mechanical ventilation, and artificial nutrition. These interventions require intensive care and are usually performed in an intensive care unit. They carry an increased risk of complications.
Possible complications
of intensive medical interventions
It is possible that organs may not recover, even with intensive medical interventions. Even if the primary affected organ does recover, other organs may have been damaged. As a result, secondary health issues can be expected. These may range from a reduced quality of life and psychological problems to permanent loss of decision-making capacity and the need for long-term care.
When my parents dealt with their advance directive, I decided to do the same. You often hear of young people becoming unconscious after a serious accident, leaving their family overwhelmed with tough decisions. I want to relieve my loved ones from that burden.
Advantages and disadvantages
of an advance directive
Becoming aware of your own wishes and goals
Respect for my wishes and preferences
Relief of my loved ones
Can be updated at any time
Time investment
Emotional burden when creating an advance directive
FAQ
Who makes medical decisions if I am incapable of decision-making and have not designated a proxy in my advance directive?
There is a legally defined order:
- Legal guardian with authority to make medical decisions
- Spouse or registered partner
- Person living in the same household
- Children
- Parents
- Siblings
Does my advance directive always take effect when I am incapable of decision-making?
If the advance directive is valid (signed and not older than two years), it will take effect, provided it is medically feasible and appropriate. This is assessed on a case-by-case basis by your medical care team together with your loved ones.
I do not understand all the questions asked in the advance directive. Where can I get more information?
In the section «Downloads & further information» you will find guidance on how to complete an advance directive. These also explain various intensive medical interventions. You can schedule an appointment with your primary care provider to discuss any remaining questions.
Summary
An advance directive is useful for everyone, regardless of age and health status. It can be adapted at any time. Discuss your preferences, goals, and questions with your loved ones and your primary care provider. Once everything is clear, complete your advance directive, date it, and sign it (every two years).
In the event of significant changes to your health or at least every two years, review your advance directive and consider if your wishes have changed. Adapt your advance directive if necessary and inform your loved ones and your primary care provider about the changes made.
Downloads & further
information
Discussion with your
primary care provider
Always discuss your thoughts, questions or uncertainties with your primary care provider. If possible, try to go to the appointment well-informed and prepared.