Live in Oregon? This article covers the Oregon version of this page.
This part of the questionnaire asks about your medical care if you ever cannot speak for yourself. That could be for a short time or near the end of life. Your answers help your attorney prepare your Health Care Power of Attorney and Health Care Directive.
Nothing you enter here is final. It is fine to be unsure, to change your mind later, or to leave parts blank.
Depending on how your attorney set up your questionnaire, these questions may be on one page. Or they may be split across two pages: Health Care and End of Life Preferences.
This article explains each question. For help thinking through your choices, see this article.
Why these questions matter
These questions help your attorney understand how medical decisions should be made if you cannot make them yourself. They show:
- How you want decisions made for you
- How much guidance, or how much freedom, you want to give the person who decides
- Whether personal, health, or religious concerns should shape those decisions
Your Health Care Agent
Your Health Care Agent is the person who makes medical decisions for you if you cannot speak for yourself. If your questionnaire includes the Fiduciary Choices page, you name that person there, under Health Care Agent (Your Health Care Power of Attorney). For what to look for in that person, see this article.
Health care preferences
These questions are about decisions your Agent may make for you while you are living.
Decisions for your minor children
If you have children under 18, you are asked: Would you like your Health Care Agent to also be able to make decisions for your minor child(ren) if you are incapacitated?
- Yes: If you cannot act and no parent is able to care for your children, your Agent can care for them, including their medical care.
- No: Your Agent’s authority covers only your own care.
Psychiatric care
You are asked: If needed, would you like to authorize your Health Care Agent to make decisions about psychiatric care on your behalf? Choosing Yes gives your Agent authority to make decisions about psychiatric care for you, within limits set by law. Choosing No does not. For those limits, see this article.
Where you would prefer care
You are asked: If you require long-term or end-of-life care, do you have a preference for where that care takes place? The choices are:
- I’d prefer care at home: You want to stay home if you can.
- I’d prefer care in a hospital or other facility: You would rather be where full-time care is on hand.
- I’m unsure, my Health Care Agent can decide what’s best: You leave the choice to the person you name.
Topics to discuss
Under Let us know if you’d like to discuss additional health care preferences, you can check any of these:
- A specific existing health condition: You have a condition now that may affect the care you want.
- Planning for potential future dementia: You want to talk about decisions that may arise if your memory or thinking declines.
- Incorporating religious or spiritual beliefs into care: Your beliefs should guide your care.
- Naming a specific Health Care Agent for my minor’s health care: You would like someone other than your own Agent to make medical decisions for your children. This box appears only if you have children under 18.
Checking a topic tells your attorney you want to talk about it. You do not need to explain it here.
End-of-life preferences
These questions ask about your general direction, not final decisions. Your attorney uses your answers to prepare documents that reflect your values.
Life support
You are asked: If you are unlikely to survive without life support, what is your preference? The choices are:
- I would like life support to be continued: You want treatment that keeps you alive, even when recovery is unlikely.
- I would like life support to be withdrawn: You want life support stopped and your care focused on comfort.
- I’m unsure and would like to discuss my options: You want to talk it through with your attorney first.
If you were pregnant
You are asked: If you were pregnant when life support decisions are made, would you want to nullify your Directive and instead allow your Health Care Agent to make decisions? Choosing Yes means that if you are pregnant at that time, your written life support wishes would not apply, and your Agent would decide instead. Your attorney can explain how your Directive applies during a pregnancy.
Organ donation
You are asked: Are you currently, or would you like to be, an organ donor? The choices are:
- Yes: You are a donor now, or want to be one.
- No: You do not want to donate.
- I am not now and I am unsure, so my agent can decide: Your Agent decides at the time.
How closely your Agent should follow your wishes
You are asked: How closely should your Health Care Agent follow your written wishes? The choices are:
- My agent should strictly follow my stated preferences: Your written wishes are firm instructions.
- My agent should use my wishes as guidance, but may ultimately decide: Your Agent weighs your wishes but can adapt.
More end-of-life topics
Under Let us know if you want to discuss additional end-of-life preferences, you can check any of these:
- Restrictions on organs to be donated: You want to donate, but with limits.
- Donation of body for scientific research: You are interested in donating your body to medical research.
- Incorporating religious or spiritual beliefs into care: Your beliefs should guide your end-of-life care.
Other thoughts
The page also has a box for anything else: If you have any other healthcare questions, comments, or concerns, please share them here: It is optional. You might use it to:
- Explain a choice you made
- Flag something you want to talk through
- Share context from your own or your family’s experience