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Making Decisions About Your Care

What Is an Advance Directive?

An advance directive is a document that allows a competent adult (person over the age of 18 years) to exercise self-determination, make decisions and give directions about future medical/surgical treatment.

You can download an advance directive form from the the District of Columbia Hospital Association website by clicking here. (Please note that Sibley Memorial Hospital is not responsible for content or forms from

An advance directive has several sections, which allow specific health directions to be given or to appoint others to make decisions if needed. These include:

A living will is a written, dated declaration which directs health care providers to cease or refrain from medical/surgical treatment should the declarant be in a terminal condition as confirmed in writing by two physicians.

A durable power of attorney for health care decisions is a document by which a person designates, in writing, another as the attorney-in-fact for medical affairs. The writing must indicate that the authority given shall not be affected if an appointee's decision-making capacity is lost.

An appointment of agent is a document appointing an agent (surrogate decision maker) to act on behalf of the appointer, when the appointer becomes incapable of expressing or making decisions in the exercise of the right to accept or refuse medical/surgical treatment.

Important Terms

A qualified patient is one who has executed an advance directive and who has been determined to be in terminal condition or in a state of permanent unconsciousness.

A terminal condition is an incurable, irreversible medical condition in an advanced state caused by injury, disease or physical illness, which will, in the opinion of the attending physician, to a reasonable degree of medical certainty, result in death regardless of the continued application of life-sustaining treatment.