Fun right? Listen, I know we're all immortal or whatever, but on the off chance that you're not you should be able to leave our fair planet on your own terms. Enter the health care proxy. I set one up because I was having surgery and was convinced I was going to die (if I had met an early demise that day, my last words would have been immortalized via text as "I wish I was eating a doughnut right now.") So let's talk some vocabulary and get down to brass tacks. I have forced everyone in my real life to do this so it's time to take on the internet.
What's a health care proxy? Your health care proxy is someone you trust (family member, friend, mentor, professor, corner deli guy) to make health care decisions for you in the event that you cannot do so for yourself. If you're temporarily unable to make health care decisions (under anesthesia, unconscious, distracted by the coffee machine), the health care proxy kicks in, but then their power is drained away once you rejoin the living. If you're permanently unable to make decisions (brain dead, dementia, unable to communicate), the health care proxy takes over.
Why do I want a health care proxy? I don't know about you but I have very specific desires about how I want to leave this planet and spend my time on it. If you don't have a health care proxy, the decisions lie in the hands of your physicians and your next of kin. Their decisions, while medically appropriate, may not be what you would want for yourself - if you don't have this conversation with them they are going to do what they think you want done (sometimes guided by their own religious or political beliefs). This means how long you would want to be on life support, whether you want your organs donated, whether you want them to do a surgery that will leave you paralyzed, etc. Personal, intimate issues that you want a say in. This also means that when they are working through their own anxiety and grief, they are trying to figure out what you would want out of life. Make their lives easier and just tell them. This goes both ways — make sure your loved ones have health care proxies as well.
Who do I choose as my health care proxy? someone you trust implicitly to follow your directions. Someone who will be accessible when shit goes down. I chose two people. My primary is my little brother. I trust him to do what I would want and not to all of a sudden succumb to the desire to keep my shell of a body breathing just because it makes it seem like I'm still there. His decisions are final, but to be made under the advisement of my father who I trust to make sure I'm actually brain dead or at a medical point I can't satisfactorily come back from. I don't want my brother to have an itchy trigger finger because he wants to inherit my books. You can give these people as much or as little power as you want. There are several people in my life who know all this on the off chance that one of my proxies is unavailable. Anyone I travel with knows the drill (I'm not a super morbid or paranoid person, I've just seen enough horrible unexpected stuff go down that I like to be prepared. And by that I mean I'm a worst case scenario person which is obviously totally different).
What if I don't like/trust/want to involve another person in this decision? OK, that's cool. I hate people as a general rule so I get wanting to keep them out of the process. You need an advanced directive.
What's an advanced directive? I'm glad you asked. It's written out directions for your medical care. The instructions are followed by your medical caregiver if you are unable to make decisions for yourself. It includes a living will which lays out the medical treatment and lift sustaining actions you want undertaken (respirators, feeding tubes, resuscitation etc). The disadvantage of this being that you can't cover every eventuality so, at some point, they may be flying blind. That's where your Health Care Power of Attorney comes into play where you name a health care proxy in the event that decisions need to be made that aren't covered by your living will.
What do I want to suss out here? Oh lots. Here's some advice. Basically talk about what you want your end of life care to look like (hydration, nutrition, and resuscitation) and what kind of life you want to lead - at what point so you want to have them officially say "no more, they wouldn't want to live like this." You can be incredibly specific in this, covering every possible scenario. Or you can be more vague and trust the people you know to follow your wishes. It's not a comfortable conversation to share (whether you are the proxy or the proxy…er) but, then again, neither is death.
OK, you've convinced me! I need a health care proxy, what now? Look up your state's policies and go from there. This is easily googled and they usually have things laid out pretty clearly. You'll need a form (that you can download off the web) witnessed and signed. You can file it with your local hospital and lawyer but also keep a copy on hand (I have one in my files, one with my proxy, and one in the mysterious thing known as the cloud).
Go forth. Read advice on this post for other end of life stuff. It's all great advice and things you should keep in mind. One thing a lot of people don't think of is a phone tree. When my friend passed away a few years ago, it was difficult to figure out who she would have wanted us to notify and include. So consider having a list of emails for people who can be relied upon to spread the word and anyone you think might get lost in the shuffle (I have all my passwords, bank info, phone list, instructions, farewells in lastpass which is technically a password storage program, not a "what if I die program" but w/e (you can save "secure notes" which are basically word documents in addition to passwords and credit card info for autofill. it's great).
Basically do whatever it takes so that people you leave behind don't have to running around trying to figure your life out. And don't forget to put in a note that they should come doxx you on GT so we can all mourn you appropriately.
If any lawyers or social workers or people in the know want to weigh in please do and I can amend this.
The rest of the "don't be scared, it's not that complicated" posts can be found here
ETA: story645 points out that a will is also important. Both in a "don't feel guilty getting rid of/donating XYZ" way and in a "goddamnit Aunt Louise, no you cannot have my sticker collection!" way. So look into that. My will is a word document but I am almost 100% sure there is a more formal way to do that
ETA: Dweeze wants you to know he'll take away all your porn, vibrators, and sex toys free of charge in the event of your unfortunate demise
ETA2: some more resource suggestions from goggly eyed plush toy:
Last night at dinner I had a long debate about Marlise Munoz, the Texan woman who is being kept on life support against her wishes because she is carrying a fetus that may or may not be viable. While it wouldn't have helped in her case (she did, in fact, have a proxy but Texas has some truly obscene laws on the books), it did throw into relief the importance of having a health care proxy and the need to talk through eventualities with the people you love. So I thought I'd repost this to encourage you all to get your acts together. Seriously, get your act together.