How to Talk to Your Doctor About Your Advance Directive: Guidance From a Doctor Who’s Seen It Firsthand

Traci Arieli
1 day ago
4 min read

Picture this: You’re in a hospital room. A loved one is in bed. Machines are beeping. Staff are moving quickly. A doctor turns to the family and asks, “Do you want us to do everything possible?”

Everyone looks at each other. No one speaks. No one really knows what everything possible means or what your loved one would want.

This situation happens more than people think. Doctors are trained to act. When there’s no clear directive, their default is to do all they can to keep someone alive: CPR, ventilators, feeding tubes, even if those measures only prolong suffering. Families often agree because they feel guilty or overwhelmed. It’s chaotic, emotional, and avoidable.

An advance directive helps prevent this. But filling out the form is only half the work. The other half is talking with those who are important to you: your significant other, family, healthcare proxies, and your doctors. That conversation, the one where you explain what really matters to you, is what gives the paper its power. In this post, you’ll learn how to prepare for that conversation with your doctor, what to bring, and how to make sure they understand what you want when it matters most.

The Biggest Misconception About Advance Directives

Most people assume that completing the paperwork is enough. It isn’t.

Many advance directives are filled out once, often with an estate attorney, then filed away and forgotten. Years go by, and your health might change. The form may no longer reflect your values.

Even when the document is up to date, its language can still be unclear. Phrases like “no heroic measures” or “natural death” might sound specific, but in a medical crisis, they leave room for interpretation. What one person considers “heroic,” another might see as routine. When wishes aren’t clear, families and medical teams tend to err on the side of doing more. That might mean aggressive interventions that the person would not have wanted.

Advance directives are often incomplete, outdated, or never shared with the people who need to see them. That’s why the conversation around the document matters just as much as the document itself.

How to Prepare for the Conversation - How to Talk to Your Doctor About Your Advance Directive

The first step to talking with your doctor about your advance directive is to plan for it intentionally. That means:

Schedule a dedicated appointment. Let the office know that the purpose of the visit is to discuss your advance directive. This ensures your doctor knows to set aside time and mental space for this topic.
Review your state’s advance directive form. You can usually find a free version online. Search “[your state] advance directive PDF” or visit the AARP website for a list by state.
Decide on your medical power of attorney. This person, also called a healthcare proxy or healthcare agent, will make decisions for you if you’re unable to speak. Choose someone who knows you well, stays calm under pressure, and follows your wishes.
Think about your values. Ask yourself: “I would want to be kept alive as long as I am still able to ___.” That blank could be walking your dog, recognizing your family, or making your own decisions. This simple statement helps you clarify what matters most.

You don’t need to have every answer, but walking into your appointment with these basics will make the conversation more meaningful.

What to Say When You’re in the Room

Many people freeze when the moment comes. They want to say the right thing or worry about sounding dramatic. Don’t overthink it.

Start simply. You might say:

“I’d like to talk about my advance directive and get your thoughts.”

That’s enough to open the door. From there, your doctor can guide the conversation based on your health, age, and situation. It’s okay if you’re unsure about specific interventions. You’re not expected to know what every term means. Your doctor can explain options like CPR, feeding tubes, or ventilators in plain language. This is also a good time to ask about what they’ve seen. What kind of outcomes are likely in situations that concern you? What should your proxy know?

Who Makes Sure Your Advance Directive Is Followed?

You may wonder who is responsible for making sure your wishes are honored. The truth is, it’s a shared responsibility.

You are responsible for clearly expressing your preferences.
Your healthcare proxy is responsible for speaking on your behalf.
Your doctor is responsible for guiding care based on your directive and current medical reality.
Your family needs to be looped in so no one is surprised or left out during a crisis.

If there’s confusion or disagreement at the bedside, doctors often default to doing more, even if that goes against the spirit of your directive. That’s why having these conversations in advance, with multiple people, is so important.

Can a Doctor Override My Advance Directive?

Yes, in some cases. For example, if your directive asks for something that is medically inappropriate or not possible, a doctor might not follow it to the letter. But the bigger risk is when doctors don’t know what your directive says, or don’t understand your reasoning behind it. That’s why talking it through matters. When your doctor knows your goals and values, they’re far more likely to follow your wishes when the time comes.

This Isn’t a One-and-Done

Think of this as an ongoing conversation, not a one-time event. Your health and priorities may change. So should your directive.

You might revisit this after:

A new diagnosis
A hospital stay
A milestone birthday
A change in your personal beliefs or lifestyle

It’s okay to adjust your preferences over time. The important thing is to keep the conversation going.

You Don’t Need to Have All the Answers

You don’t have to walk into your doctor’s office with everything figured out. What matters is that you start. Think about what matters to you. Choose someone you trust. Bring your questions. This is a conversation that gives your values a voice, even when you can’t speak for yourself. And once it’s had, it often brings relief, not just to you, but to the people who love you.