Make several photocopies of the completed documents.  Keep the original documents in a safe but easily accessible place, and tell others where you put them; you can note on the photocopies the location where the originals are kept.  DO NOT KEEP YOUR ADVANCE DIRECTIVES IN A SAFE DEPOSIT BOX.  Other people may need access to them.

Give photocopies to your agent and alternate agent.  Be sure your doctors have copies of your advance directives and give copies to everyone who might be involved with your healthcare, such as your family, clergy, or friends.  Your local hospital might also be willing to file your advance directives in case you are admitted in the future.

Once you have completed your advance directive you need to talk to anyone who might be involved in your health care decision making.  This includes relatives, friends and your healthcare providers.  You want them to understand how you feel about medical treatment at the end of life.  If you have appointed a health care agent, it is very important that they know your wishes. 

How you can be sure your advance directives will be honored

Simply completing advance directives will not ensure that your wishes will be honored. These documents are tools to help the decision making process.  Their effectiveness depends largely on the way you prepare your loved ones and other caregivers for their use.

To best protect your treatment wishes, you should do two things:

• Take the time to think your feelings through and state them fully, so that your advance directives truly reflect your treatment wishes.
• Talk openly about your wishes with your family, your friends and your doctor.

Don't assume that others will know what you would want.  Research shows that families' and physicians' guesses about a patient's preferences often are mistaken.  Talking with the people who might have to act on your behalf ensures that they understand your wishes, gives them a chance to ask questions, and lets you determine whether they will follow your wishes even if your choices differ from theirs.

Many states' laws explicitly honor out of state directives as long as they do not conflict with that state's own law and other state statutes don't address the issue.  In fact, a state would probably have to honor an advance directive that clearly expressed your treatment wishes, because your constitutional and common-law rights to accept or refuse treatment may be even broader than your rights under a specific state law. However, if you spend significant time in more than one state, we recommend that you complete the advance directives for all of the states involved.  It will be easier to have your advance directives honored if they are the ones with which the medical facility is familiar.

Generally, advance directives are not effective in a medical emergency.  There is no time in an emergency either to consult the directions in an advance directive or determine a person's underlying medical condition.  Once the person comes under the care of a physician, the contents of a living will can be evaluated and the instructions of a health care agent determined in light of that person's overall prognosis.

What happens if my doctor (or family) won't honor my wishes?  There is no simple answer to this question.  For this reason it is essential that you have honest and open discussions with your agent, family members and physician about their willingness to support and if necessary advocate that your wishes are carried out.  If you find they are not willing to support your choices, you may wish to consider appointing a non-family member who will honor your wishes or change your physician before a conflict arises.