Advance Directives

New Hampshire could soon have a new system for determining who gets to make medical decisions on behalf of patients who lack the ability to do it themselves.

A bi-partisan group of lawmakers, including Democratic Senator Peggy Gilmour, are pushing a bill that creates what’s called a surrogate decision-maker system.

“I think people assume that, for instance, I could speak for my husband,” says Gilmour. “Or, one of my children could speak for me. But that’s just not the case.”

FDII / Flickr Creative Commons

Tackling the taboo on discussing death:  in a series last week, NHPR’s health reporter Todd Bookman examined this movement to encourage end-of-life planning- from the legal concerns of living wills and health care proxies, to the emotional side of managing family dynamics around this most difficult issue. 


Todd Bookman / NHPR

Advance directives—sometimes called living wills—let people decide who can make medical decisions for them and what invasive treatments should be avoided at the end of life. Many in the healthcare system say they are vital plans that ensure a patient’s voice is heard, but only 25% of Granite Staters have signed advance directives.

In this series, Health Reporter Todd Bookman looks at efforts to increase that number, gives an introduction to the form and its latest re-write. and examines the impact of not having a completed advance directive.

Sometimes, even thoughtful planning for the end of one's life can't foresee all the possible outcomes.

That was certainly the case for Reverend Canon Randy Dales of Wolfeboro, and his father-in-law. Canon Dales is a vocal advocate for the use of advance directives to maintain dignity in death, with his position formed by four decades of ministry and 30 years of work in a hospice he co-founded.

We continue our series on advance directives in New Hampshire with this audio postcard.

Other Stories In Our Series

Todd Bookman / NHPR

This week, we’ve been looking at end-of-life planning in the Granite State, and some efforts to streamline and increase the use of  advance directives--the legal documents that let people name who can make medical decisions for them and what treatments should be avoided to preserve dignity. We continue our series with this look at what can happen when there is no plan in place, forcing the medical system to turn to the legal system for answers.

Dr. Tim Lahey prefers to spend his days in hospitals and clinics, not courtrooms.

Todd Bookman / NHPR

A survey from the National Hospice Foundation finds that Americans are more comfortable talking to their kids about sex than they are talking to their elderly parents about death. End-of-life remains simply a taboo subject in many households. But these important conversations are necessary to create the living wills that can help keep dignity in dying. We continue our 3-part series on advance directives with this look at efforts around the state to get more people talking, and planning, for their end-of-life.

Sara Plourde / NHPR

The terms used in advance directive forms can be tough to understand and have the possibility for misinterpretation, given that their specific legal definitions can sometimes clash with common usage. Understanding the terms on the forms is vital to creating an advance directive that is properly representative of one's wishes.

As part of his series looking at the issues and changes around advance directives in New Hampshire, NHPR's health reporter Todd Bookman explains the following terms as they relate to end-of-life planning:

Todd Bookman / NHPR

New Hampshire’s advance directive form got an update Monday. Governor Hassan signed a bill that seeks to streamline and simplify the document.