Values History for Health Care
AIDS Legal Services Project

Your Thoughts on Health Care

1. Do you like your medical doctors?
2. Do you trust your medical doctors?
3. Do you think your medical providers should make any final decisions about the treatment you might need?
4. Any other thoughts about your doctor and other health caregivers?

Your Thoughts on Independence and Control

1. How important is independence and self-reliance to you?
2. If your physical and mental abilities decrease, how would that affect your attitude toward independence and self-sufficiency?

Your Personal Relationships

1. Do you think your friends and family will support the decisions you want to make regarding medical treatment that is needed now or in the future?
2. Have you made any arrangements (formally or informally) for family or friends to make medical treatment decisions for you?  If so, who has agreed to make these decisions and under what circumstances?

Your Attitude about Illness, Dying, and Death

1. What will be important to you when you are dying (physical comfort, no pain, family members present, etc.)?
2. Where would you prefer to die?
3. How do you feel about the use of life-sustaining measures?

Your Wishes Regarding Final Arrangements

1. Have you thought about what final arrangements you’d like to make? Would you prefer burial or cremation?  Memorial service?  Obituary notice, if so, which newspapers?
2. Have you made any final arrangements yet? If so, with whom?  Do you have concerns about covering the costs?  Maybe you already have a small life insurance $10-$15,000 to cover expenses? 
3. Do you have any specific instructions about how your funeral, burial, or cremation should be conducted?  Who should lead it?  Any favorite music you’d like to have played?

Donation of Organs & Autopsy

1. Until very recently, people living with HIV generally could not donate their organs unless it was for medical research. Now, select institutions are providing organ transplants from one person living with HIV to another. Are you interested in being an organ donor?
2.  Do you wish to have an autopsy performed?