Live in Washington? This article covers the Washington version.
This article helps you think through your health care wishes before you answer the questions about them. It is written for Oregon residents.
Filling in your questionnaire now? See the help for the health care questions. For choosing the person who makes decisions for you, see this article.
Your Oregon Advance Directive
In Oregon, your health care wishes go in one document, the Advance Directive. It names your Health Care Representative, the person who speaks for you when you cannot. It also records your instructions about your care.
Oregon law sets out the form, so much of it looks the same for everyone. You can see the state form, and a guide to filling it in, on the Oregon Health Authority website. The Advance Directive your attorney prepares follows this form and may add instructions.
One step is often missed. Your Representative must accept the role in writing. Until they sign, the appointment does not take effect.
Life support: three situations
Life support means treatment that keeps you alive when your body cannot do it on its own. Examples are CPR to restart your heart, a breathing machine, and tube feeding.
The form asks what you want in each of three situations:
- A terminal condition: An illness that cannot be cured and is expected to cause death within six months.
- An advanced progressive illness: An illness that will only get worse. You will never again be able to communicate, swallow safely, care for yourself, or recognize your family.
- Permanent unconsciousness: You are unconscious and very unlikely to wake up.
For each situation, you initial one of four options:
- Try all treatments to keep you alive, such as tube feeding, IV fluids, kidney dialysis, and a breathing machine.
- Try tube feeding and IV fluids, but no other treatments to keep you alive.
- No treatments to keep you alive. Be kept comfortable and allowed to die naturally.
- Let your Health Care Representative decide, after talking with your doctors.
You can make a different choice for each one. For example, you might want every treatment if you are terminally ill, but none if you are permanently unconscious.
Your own experience often shapes your answer. Maybe you sat with a parent in intensive care, or your faith guides you. It is fine to be unsure and to want to talk it through with your attorney.
What matters most to you
Your choices above cannot cover everything. This part of the form tells your Representative what makes life worth living for you.
You can initial abilities you would not want to live without, such as knowing who you are or being free from long-term severe pain. If you could no longer do those things, you would not want treatment to keep you alive.
Other parts cover your spiritual beliefs, your life and values, and where you would prefer care. You can also name people your Representative may let your doctors talk with.
Adding your own instructions
The form lets you add instructions of your own. Many people use this to spell out powers they assume their Representative already has. The law does not list most of these powers in so many words, so writing them down removes doubt.
Common additions give your Representative the power to:
- Manage your health care generally
- Make choices about life support for you
- Hire and fire people who help with your medical care
- Work with your financial agent to pay for your care
Some people also add a wish that their treatment be kept comfortable and pain free. Your questionnaire lists each of these, so you can check any that fit.
Why the life support power matters
Oregon law limits when your Representative can refuse or withdraw life support. Without this power in your Advance Directive, they can do it only if your doctors confirm one of these situations:
- You have a terminal condition.
- You are permanently unconscious.
- Treatment would not help you and would cause you permanent and severe pain.
- You have an advanced progressive illness, as described above.
In any other situation, your Representative cannot refuse or withdraw life support for you. That is true even if they know it is what you would want.
For example, you might be on a breathing machine after a severe stroke, but not be terminally ill or permanently unconscious. Without this power, your Representative could not decide to stop the machine.
Giving your Representative this power lets them follow your wishes in any situation.
Where you would like to receive care
If you ever need long-term or end-of-life care, where would you want to be? The questionnaire offers three answers:
- 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 Representative can decide: You leave the choice to the person you name.
Staying home often depends on family help and paid caregivers, which can be costly. Even so, saying what you would prefer helps the person you name. If they are ever called on to act, they will know what matters to you.
Organ donation
The questionnaire asks whether you are, or would like to be, an organ donor. If you are unsure, you can leave it to your Representative. You may already be registered, for example when you got your driver license.
After your death, your Representative can act on your organ donation wishes. Telling them now spares your family from guessing at a hard moment.
Mental health care
Oregon has a separate document for mental health care, the Declaration for Mental Health Treatment. It records your preferences, such as medications that have worked for you, and can name someone to make mental health decisions. It lasts three years unless you cancel it sooner.
Your Health Care Representative cannot consent to some treatments, such as electroconvulsive therapy. If mental health care may matter for you, ask your attorney about a Declaration for Mental Health Treatment.
Dementia
Dementia is different from a sudden illness. It can last for years, and what you would want may differ from one stage to the next.
The form’s advanced progressive illness situation can describe late-stage dementia, when you can no longer recognize your family or care for yourself. If dementia worries you, raise it with your attorney.
POLST: medical orders for serious illness
A POLST form is not a legal document like the others. It is a medical order you fill out with your doctor, usually when you are seriously ill. It tells an ambulance crew right away whether you want CPR and other treatments.
Your legal documents speak for you through the person you name. A POLST speaks for you directly in an emergency, before anyone can reach your Representative.
Oregon keeps a statewide POLST registry, so emergency teams can look up your form. Your form goes to the registry unless you choose to opt out.
Death with Dignity
Oregon’s Death with Dignity Act lets a capable adult with a terminal illness ask for medication to end their life. The request must come from you, while you can still make it. Your Representative cannot ask for you, and no health care document can.
Practical tips
- Talk with the person you name and with your doctor. A short conversation now makes their decisions much easier later.
- Tell them where your documents are, and give copies to your doctor, any care facility, and close family. A document no one can find cannot help you.
- Look at your documents again when your health changes. They do not expire, but your wishes might change.
- Before you move into a care facility, ask whether its policies limit any of your wishes. Some facilities will not honor every choice.
Want to read more?
These articles are optional.
- Choosing the person who decides for you: What to look for, and what happens if you name no one. See this article.
- Final arrangements: Planning for after your death. See this article.
- Glossary: Common estate planning terms. See this article.