Horizon Planning

Everyone has a health horizon. Let’s plan for it.

The first and most important step, regardless of your age, is to have a conversation with the people most important to you and your primary care doctor.

This should be a two-sided conversation. Knowing your preferences might take some of the burden off the people most important to you.

The Conversation Starter Guide from The Conversation Project is dedicated to helping you talk about your wishes for end-of-life care. This can help you organize your own thoughts and support your conversations with loved ones.

The next step is to get your wishes down in writing — with legal forms. These medical decision documents are known as advance directives.

The different kinds of advance directives can help you plan, organize and document your wishes so they can be known and followed if and when the situation arises.

Anatomical gifts (organ donation)

If you're at least 18 years old, you may make a lifesaving anatomical gift of your entire body or of body parts (including organs, tissues, eyes, bones, arteries or blood).

You can either express your wish to do this in your living will, or grant the specific power to make an anatomical donation in a power of attorney for healthcare.

Learn more about anatomical gifts from the Gift of Life Donor Program.

Gift of Life Contact Information

2000 Hamilton St., Suite 201
Philadelphia, PA 19130-3831
1-800-KIDNEY1 (543-6391)
1-800-DONORS1 (366-6771)

To donate your body to science, research or education, contact the Humanity Gifts Registry in Pennsylvania at hgrpa.com or 215-922-4440.

In Pennsylvania, adults generally have the right to decide if they want to accept, reject or stop medical care and treatment.

To protect and safeguard this right, however, it may be necessary to execute advance directives such as a living will or power of attorney for healthcare. (These forms are both included in the Five Wishes booklet.)

For example, under a criminal law known as Act 28 of 1995, caretakers such as owners, managers or employees of nursing homes and other health institutions are required by law to give necessary medical care to their patients, unless they can demonstrate that the patient has competently refused the care or treatment or has an advance directive indicating that they don’t wish to receive such care.

Your doctor should give you all the information that a person in your situation reasonably would want to know to make an informed decision about the procedure or course of treatment they’re proposing.

This means they should tell you about the risks and benefits of the recommended procedure or treatment, possible side effects and any alternatives you could choose. You may accept or reject your doctor's advice, and you may seek a second opinion.

Ask your doctor for What Matters to Me: A Workbook for People with Serious Illness©, created by Ariadne Labs and The Conversation Project, an initiative of the Institute for Healthcare Improvement (IHI).

Generally yes, but there may be exceptions based on their policy. For example, upon admission to a hospital, you must be informed if the hospital will not honor your wish to have food and water withheld or withdrawn under certain circumstances.

The law requires your health care provider (hospital, nursing home, home health care service, hospice or HMO) to give you a written statement of its policies.

There’s no law in Pennsylvania guaranteeing that a health care provider will follow your instructions in every circumstance.

However, you can take steps to help ensure that your wishes will be followed later, in case you become physically or mentally unable to make a decision about your medical care or treatment:

  • Express your wishes about future treatment — have the conversation today with family, loved ones, people important to you and your health care team.
  • Complete the Five Wishes booklet so there is a record of your wishes for care.
  • Make sure you name at least two, preferably three, people to be your health care agents so they can legally advocate for your care, especially your own wishes and goals for end-of-life care.

The best way to have your wishes honored for end-of-life care is by creating advance directives. You can determine if your health care agents can change anything in your living will, or if they must follow your wishes under all circumstances. You’ll give them the authority you want them to have in writing in your living will and power of attorney for healthcare.

Then, if family members disagree or have questions, your doctor can discuss your living will to determine the best treatment options based on your wishes. This is also why choosing a power of attorney for healthcare (health care agent) is so important — the trusted person you name is the one making the decisions you would want.

Above all, having the conversation today to share your wishes with all family members, loved ones or the people most important to you helps ensure they’ll support the choices you’ve made now.

If there’s a question that can’t be resolved, your health care team will consult with WellSpan’s legal department and/or the courts to determine the appropriate course of action.