BEHAVIORAL HEALTH RISK FACTOR SURVEY (BRFSS)
End-Of-Life Questions -- 2010
ATTACHMENT 3
Personal Preference and Public Understanding

1. Have you ever discussed with your family how you would want to be treated if you were dying?

2. Have you ever discussed with your doctor how you would want to be treated if you were dying?

3. Have you completed a written advance directive such as a living will or medical power of attorney that says who you would want to make medical decisions for you if you could not make them for yourself?

	Living will only
	Medical power of attorney only
	Both a living will and a medical power of attorney
	Neither
	Never heard of either

4. How would you respond to the following statement? It is important to talk with my family and doctor about how I want to be treated at the end of life:

	Strongly agree
	Agree
	Neutral
	Disagree
	Strongly Disagree