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home : columns : dr. k May 24, 2016

12/20/2013 9:13:00 AM
Advance medical directives should be readily available

DEAR DOCTOR K: This isn't really a medical question, but I hope you'll answer it anyway. Where should I keep my advance medical directive?

DEAR READER: You raise an important issue, and I'm happy to address it. In fact, your question is timely, because I have just discussed with my lawyer where to store my advance medical directive. Let me tell you what I've learned.

For readers who are not familiar with the term, advance directives are documents that allow you to describe what kind of medical care you hope to receive if an accident or illness renders you unable to communicate. The health-care power of attorney, living will and do-not-resuscitate order (DNR) are all advance directives.

Some people worry that advance directives mean giving up control over their medical treatment. But as long as you are able to communicate decisions, your word overrides anything you've written. In fact, I think of my advance directives as my way of maintaining control over how I am treated, should I become critically ill.

Advance directives enable you to choose the person (your agent) who will make medical decisions for you when you are unable to do so. Using directives, you may offer as much or as little guidance as you like.

Many people understandably want to keep their advance directives in a secure place. But if these documents are locked away in a safe-deposit box, they won't be much help if you're unexpectedly hospitalized.

Here are some people who should have copies of your advance directives and other places they should be filed:

-- Your health care agent.

-- Your doctor. A copy of your advance directives should be in your file and medical record.

-- Your hospital chart. If there is one hospital where your doctor is likely to hospitalize you, ask to have a copy of your advance directives put in your chart.

-- A safe spot in your home. File the original documents in a secure place in your home. Tell your agent, family and friends where you put them.

-- Carry it with you. Put a card with your health care agent's name and contact information and where you've put the original copy of your directives in your wallet or purse.

-- In the glove compartment of your car. A colleague of mine recommended this, and it seems like a good idea to me.

When I completed my first advanced medical directive, I was a healthy adult in mid-life. I had a very small risk of becoming seriously ill. But I wondered why it had taken me so long. At any age, and in any state of health, bad things can happen. Hopefully, that time will never come for me. But if it does, I want to control how I'm treated.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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