If you became unable to speak, who would make your medical decisions? That’s the question being raised throughout the country on April 16.

That date marks the Ninth Annual National Healthcare Decisions Day, a nationwide event promoting the importance of healthcare choices and advance care planning. This day is a reminder for us all to take steps to ensure that our wishes are followed in times of crisis.

Advance medical planning is of particular importance to the LGBT community, because our support systems frequently fall outside of traditional “family” structures. The friends and loved ones you rely on and know best may have little power to speak for you when you need it most, unless you take specific steps ahead of time.

“If you do not have a health care proxy or an advance directive set up, and you’re not married, a parent or sibling could be in charge of your health care decision making, regardless of your relationship with that person,” said Bethany Henderson, program manager of the SAGECAP (SAGE Caring and Preparing) program at Chase Brexton Health Care’s LGBT Health Resource Center in Baltimore, Maryland. “If there’s no family available, these decisions could end up being made by doctors who never met you in a conscious state.”

There are two important ways to protect yourself: you can make your own decisions in advance by putting your wishes into a formal document often known as a Living Will, or you can use an advance directive to designate a Health Care Proxy (sometimes called a Health Care Agent, Surrogate, or Power of Attorney) who will make medical decisions on your behalf. Many people do some combination of the two. 

Advance directives in the U.S. vary a bit from state to state, but the forms are free and most do not require a lawyer to complete. This list of resources provides several places to find state-specific forms, as well as a number of helpful tools to help in planning, discussing, and filling out your advance directives: http://www.nhdd.org/public-resources

It’s important to note that simply completing advance directives isn’t enough; the people who might use them need to know that they exist and be able to access them. Give copies to your physicians, talk to friends and loved ones about them, and have detailed discussions with anyone you plan to name as a health care proxy (you should also provide them with the original copies of the forms). You might consider carrying a note in your wallet stating that you have an advance directive, along with instructions on where to find it or who to call in an emergency.

Thanks to marriage equality, same-sex spouses now have significantly more protection, in that a legal spouse would be the first in line to speak for someone who is incapacitated. That doesn’t make advance planning any less important, though. You should talk with your spouse specifically about your wishes, in the same way you would when designating a health care proxy, and you should be sure that you understand their wishes as well. This isn’t a matter of mistrust - knowing the patient’s own wishes can significantly ease the burden of making important decisions at a difficult time.

No one likes to talk about the “what ifs” of medical and end-of-life care, but it’s a necessary step that we each need to take to protect ourselves. The theme of this year’s National Healthcare Decisions Day is “It Always Seems Too Early, Until It’s Too Late.” Please don’t put off these important steps until it’s too late—protect yourself now by putting your advance directives in place. 

For more information on End of Life Decisions, visit the resources on the following websites:

National Resource Center on LGBT Aging

National Healthcare Decisions Day

National Healthcare Decisions Day- Advance Care Planning Resource List

In Maryland, the SAGECAP Program is available to assist members of the LGBT community with these and other important life-planning issues.