Advance Medical Directive

Protecting your right to choose or refuse medical treatment

All competent adults have the right to accept or refuse any medical treatment. Competent means you understand your condition and the results your decision may have. But what happens if you become too ill or injured to make your own decisions about your medical care? How will your family and physicians know what treatment you would choose?

You can plan ahead by writing an Advance Medical Directive. Advance directives are documents signed by a competent person giving direction to healthcare providers about your future medical care should you become unable to make those decisions yourself.

The Colorado Health Foundation has funded an Advanced Care Planning Project to support community-wide conversations and documentation of end-of-life wishes. For more information about resources and workshops, click here.

There are two kinds of advance directives: a medical durable power of attorney and a living will.

A Medical Durable Power of Attorney for Health Care Decisions lets you name another person-known as a patient advocate, agent or proxy-to make medical decisions for you. You can select a family member, friend or any other person you trust, but be sure they are willing to serve in this role. Your advocate can speak for you if-and only if-you can't state your wishes yourself. Your advocate can also talk with your doctors for you about the risks and benefits of medical treatments in specific situations.

A living will, known in Colorado as a Declaration as to Medical or Surgical Treatment, lets you explain in writing which medical treatments you would choose or refuse at the end of your life. A living will takes effect only when you are at the end of your life and can no longer express your wishes yourself.

Medical treatment at the end of your life generally falls into three main categories: life supporting, life sustaining and life enhancing.

Life-supporting care
refers to CPR, machines and medications that keep your heart and lungs going when they can't work on their own.
Life-sustaining care involves treatment and machines that can prolong your life when your condition can't be reversed or cured.
Life-enhancing care keeps you comfortable until death occurs naturally. Nothing is done artificially to prolong your life.

Once you know what your treatment wishes are and who your agent is, inform your family and your doctors. Try to talk with them before you become seriously ill. In a medical crisis, your family might not agree on the care you would want. Or your doctor might order treatment that differs from what you would choose for yourself.

Click here to download and print forms for Declaration as to Medical or Surgical Treatment and Medical Durable Power of Attorney for Health Care Decisions.

HRRMC policies mandate that as long as you are a competent adult, you are the only person who can decide what medical treatment you want to receive. If you are unable to make decisions, we first seek instructions from the patient advocate named in your durable power of attorney. If there is no durable power of attorney, we rely on your living will.

If you have not written an advance directive, we try to determine your wishes based on any oral or written statements you have made. We may talk with your family about what your wishes would be and how to fulfill them.

If we are sure about what you would want, we try to follow your wishes. If we are not sure or if there is disagreement about whether to treat you or not, we will continue to provide care, although we may ask a court to appoint a guardian to make decisions for you. Our goal is to understand and carry out the choices you would make for your medical care.

Treatment decisions can be difficult, but an advance medical directive lets you tell your family and your doctors what medical care you want, if a time comes when you can no longer express those desires yourself. An advance directive helps provide peace of mind because you've made your wishes known.

For more information about advance medical directives at HRRMC, please contact our discharge planning office at (719) 530-2284. For information about advance medical directives in Colorado, visit

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