When you meet with your attorney for the preparation of a medical directive, your attorney will need basic information, as follows:

Identification of the Parties:

Yourself
Full legal name
Complete address
Telephone numbers (busiess and home)
Date of birth

The person you wish to name as your primary Health Care Agent
Full legal name
Complete address
Telephone numbers (business and home)

Other individuals you wish to designate in the event the primary Health Care Agent is unable or unwilling to act (name the first successor Health Care Agent - then the second, third, etc.).

For each individual you wish to name as a successor Health Care Agent:

Full legal name
Complete address
Telephone numbers (business and home)

Your current primary care physician
Full name
Complete address
Telephone numbers (office and emergency)


Health Care Issues to be Discussed:

In addition to the basic information stated above, it is important that you be prepared to discuss various health care issues and medical treatment options with your attorney. You should be prepared to tell your attorney:

At what point in time your Health Care Agent is authorized to exercise the powers you have granted?:

What types of powers you wish to grant to your Health Care Agent?:

What instructions are to be given in the event your doctor determines you are terminally ill?
In regard to what are commonly known as "life-sustaining treatment" or "death- delaying procedures" your agent may be faced with having to make a decision, or a series of decisions, which will either prolong or hasten the moment of your death. In situations where an individual's medical condition has been diagnosed as terminal and the application of either "life-sustaining treatment" or "death-delaying procedures" is appropriate, individuals in their medical directives have traditionally given their Health Care Agents one of the following additional instructions, each of which should be the subject of discussion with your attorney:

1.	A statement that you neither want your life to be prolonged nor want life-sustaining treatment to be provided or continued, in the event your Health Care Agent believes the burdens of the treatment outweigh the expected benefits. Normally, individuals add a request to this statement that their Health Care Agent consider the relief of suffering, the expense involved and the quality, as well as the possible extension, of life in making decisions concerning life-sustaining treatment.
2.	A statement that you wish to live and enjoy life as long as possible, provided however that you do not wish to receive medical treatment which would only delay the moment of your death from an incurable and terminal condition or prolong an irreversible coma. For purposes of this statement, the following definitions are frequently added: (a) "terminal condition" shall refer to an incurable and irreversible condition which is such that death is imminent and the application of death-delaying procedures serves only to prolong the dying process; and (b) "irreversible coma" shall refer to a permanent loss of consciousness from which your attending physician believes, according to reasonable medical standards at the time of reference, there is no reasonable possibility that you will return to a cognitive and sapient life, and shall include but not be limited to a persistent vegetative state.
3.	A statement that you wish to live and enjoy life as long as possible, and further that you want your life prolonged to the greatest extent possible without regard to your condition, the chances you have for recovery or the cost of the procedures.

When giving consideration to including a statement as set forth in either Paragraph 1 or 2 above, individuals customarily grant additional powers to their Health Care Agents to be exercised in the event the medical conditions set forth in Paragraphs 1 or 2 exist. Typical of such powers are the following:

1.	To direct that treatment or procedures which will only postpone the moment of your death or prolong an irreversible coma be withheld or, if previously instituted, that such treatment be withdrawn;
2.	To direct that procedures other than manual feeding utilized to provide you with nourishment and hydration (including, for example, all forms or intravenous and parenteral feeding, all forms of tube feeding, and misting) be withheld or, if previously instituted that such procedures be withdrawn;
3.	To sign on your behalf any documents necessary to carry out the powers you have granted to your Health Care Agent (including waivers or releases of liability required by any health care provider);
4.	To direct that a "No Code" or "Do Not Resuscitate" order be placed in your medical records; and
5.	To order whatever is appropriate to keep you as comfortable and as free of pain as is reasonably possible, including the administration of pain-relieving drugs, surgical or medical procedures calculated to relieve your pain; and conventional pain-relief therapies which your Health Care Agent believes may be helpful, even though such drugs or procedures may lead to permanent physical damage, addiction or hasten the moment of (but not intentionally cause) your death.

Express Your Intent - Clearly and Concisely

Remember, a medical directive is a legal document. Your medical directives should be kept simple and concise so that they may be easily understood, yet definite and specific enough so that they effectively expresses your intent at a time when you are unable to speak for your self. No one is able to look into the future and determine what type of medical treatment they may need or know in advance exactly what types of medical treatment alternatives will be available at a time of need. Accordingly, your medical directives should expressly set forth your intent and directions regarding the medical treatment you want to receive, while at the same time expressing your intent and directions that other types of medical treatment not be implemented or, if previously implemented, that they be withdrawn.