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Advance Directives – Difficult Decisions

Anyone who has executed a NH Advance Directive for Healthcare knows there are some tough choices to make when making your wishes known to your Agents.  Healthcare Directives in New Hampshire are drafted in compliance with statutory provisions, or mandatory format in accordance with the lawNHRSA 137:J .  Because of this, some of the language required can be confusing to the layperson.  We at Morneau Law are here to help ease our Clients through this sometimes-daunting task.  It’s never pleasant to face one’s mortality or to think about end of life choices, especially during a pandemic.  However, when Clients get their estate plan completed, they almost always report a sense of relief and accomplishment.  It is an act of love to prepare for the future so that families and loved ones are not faced with bureaucratic challenges during already emotionally charged situations.    

What is the Most Difficult Question or Choice on the NH Advance Directive?

The one question that confuses people the most is the one that relates to treatment over objection.  To remain in compliance with the statutory mandates, the question in the NH Advance Directive looks like this:   

“Treatment Against Objection 

(Initial beside your choice of (a) or (b)) 


____(a) Even if I am incapacitated and I object to treatment, treatment may be given to me against my objection. 



____(b) Even if I am incapacitated and I object to treatment, treatment may not be given to me against my objection.  

 What does that Mean?

It needs to be noted that Health Care Directives are “activated,” or come into play only when the Patient cannot make medical decisions on their own.   Doctor or Advanced Practice Registered Nurse (APRN) must make that determination by clinical evaluation and only then can the Power of Attorney for Healthcare be utilized.  Keeping in mind that the Patient is not of sound mind, or is incapacitated, the question is asking whether the Patient is willing to give permission to the Patient’s Doctor or APRN to allow the Patient’s chosen Agent’s medical decisions to override the verbalized wishes of the now incapacitated Patient.    

 What Might this Look Like?

Here is an example that our estate planning Attorneys often use with Clients:  Sometimes elderly patients suffer from Urinary Tract Infections, (UTI), and this can sometimes cause temporary dementia.  This is an issue that is frequently rectified by taking antibiotics.  If the Patient is experiencing dementia, but still has the ability to speak and in their demented state believes the antibiotics are poisonous or harmful to them, even though they are likely to resolve the infection, choosing “A” on the Health Care Directive gives the Patient’s chosen Agent the authority to  override the Patient and get them the care that they need.   


This is the most difficult question on the Health Care Directive for New Hampshire.  There are other choices to be made and other provisions to be made via other types of documents, depending on your goals.  Call or Contact Us today to schedule a complimentary video chat or telephone estate planning consultation so that our experienced Attorneys can outline your options for you and you too can get  sense of relief and accomplishment by taking care of business so that your family and loved ones won’t have to.  Call us today at 943-5647 and we are happy to speak with you.    

Alycia Gelin