Practical Guide to Advance Healthcare Directives and Living Wills in Monteagle
Advance healthcare directives and living wills let individuals in Monteagle make clear decisions about medical care before a health crisis arises. At Jay Johnson Law Firm, located in Tennessee, we help clients understand the documents available under state law, how they function, and how they interact with other estate planning tools. This guide provides straightforward information for residents of Marion County who want to document their preferences for life-sustaining treatment, appoint someone to make healthcare decisions, and avoid uncertainty for family members during stressful times. Clear planning can reduce disputes and preserve dignity when medical decisions become necessary.
Creating an advance healthcare directive or living will is a deeply personal process that benefits from careful thought and plain-language drafting. For people in Monteagle, these documents translate values and wishes into actionable guidance that medical teams and loved ones can follow. In Tennessee, certain formalities must be met for the documents to be valid, and it helps to know the best ways to communicate your choices to doctors, family, and caregivers. This section describes basic steps to begin planning, including gathering medical history, discussing preferences with family, and identifying a trusted decision maker to act on your behalf.
Why Advance Healthcare Directives Matter for You and Your Family
Advance healthcare directives and living wills offer clear benefits by reducing uncertainty and guiding medical decision making when a person cannot speak for themselves. These documents can specify preferences about life-sustaining treatments, pain management, and organ donation, while naming a trusted healthcare agent to advocate for your wishes. For families, having directives in place eases decision-making pressures and helps avoid conflict during emotionally charged moments. Properly drafted directives also support medical teams in delivering care that aligns with the patient’s values, ensuring personal choices are respected and documented in a way that is recognized under Tennessee law.
About Jay Johnson Law Firm and Our Approach in Monteagle
Jay Johnson Law Firm serves Tennessee clients with a focus on clear, practical estate planning and probate services, including advance healthcare directives and living wills. Our approach emphasizes listening to each client’s goals and translating personal wishes into legally effective documents that reflect those priorities. We assist residents of Monteagle and Marion County with step-by-step guidance, ensuring paperwork meets state requirements and is easy for family members and healthcare providers to follow. The firm is reachable at 731-206-9700 for questions and consultations about creating or revising health care directives and related planning documents.
Understanding Advance Healthcare Directives and Living Wills in Tennessee
Advance healthcare directives and living wills are legal tools that allow an individual to articulate their medical care preferences ahead of time. In Tennessee, these documents can address preferences for life-sustaining treatment, pain relief, and other end-of-life care decisions. A durable power of attorney for health care typically names a decision maker, while a living will records specific treatment wishes. Understanding how these documents interact, when they take effect, and how they are interpreted by medical professionals and family members helps ensure that your choices are honored under applicable law and that your loved ones are given clear instructions during difficult circumstances.
It is important to know the formal requirements and practical considerations when preparing advance directives in Tennessee. Properly witnessed or notarized documents, clear language, and distribution to relevant parties increase the likelihood that directives will be followed. Guidance can include how to express preferences for resuscitation, mechanical ventilation, feeding tubes, and hospice care, while also explaining how to appoint a healthcare agent and what powers that person may have. Thoughtful preparation reduces ambiguity and can prevent delays, disagreements, or unnecessary interventions when time-sensitive medical choices are needed.
What an Advance Healthcare Directive and a Living Will Mean
An advance healthcare directive is a broad term for written instructions that describe what types of medical care you want if you are unable to communicate. A living will is a form of advance directive that focuses on end-of-life preferences, specifying whether to receive or decline life-sustaining treatment under particular medical conditions. Together, these documents work with a durable power of attorney for health care, which names the individual who will make decisions consistent with your wishes. Clear definitions and straightforward language help ensure these instruments function as intended and are recognized by healthcare providers in Tennessee.
Key Components and Steps to Create Your Directive
Preparing an advance directive involves several steps: identifying your goals and values about medical care, selecting a trusted agent to act on your behalf, describing specific treatment preferences, and ensuring legal formalities like signatures and witnesses are satisfied. Once drafted, it is important to distribute copies to your chosen agent, family members, and medical providers, and to discuss your wishes so those people understand your choices. Periodically reviewing and updating directives ensures they remain aligned with changing medical circumstances or personal preferences, and documenting revisions clearly avoids confusion about current instructions.
Key Terms and Glossary for Advance Healthcare Directives
Knowing common terms related to advance directives and living wills helps you make informed decisions and communicate effectively with medical providers and family. This glossary highlights words and phrases you will encounter while planning: advance directive, living will, healthcare agent, durable power of attorney, life-sustaining treatment, and capacity. Understanding these definitions clarifies how each document operates, which decisions each covers, and what legal requirements apply in Tennessee. Clear terminology also assists in drafting documents that reflect your intent and in explaining those choices to those who may act on them.
Advance Directive
An advance directive is a legal document that communicates a person’s preferences for medical treatment in the event they cannot speak for themselves. It may include a living will component that addresses end-of-life care and a designation of a healthcare agent who can make decisions consistent with the person’s wishes. Advance directives guide healthcare providers and family members on whether to start, withhold, or withdraw certain treatments under specified circumstances. Having an advance directive can prevent misunderstandings and help ensure treatment aligns with the individual’s values and priorities.
Durable Power of Attorney for Healthcare
A durable power of attorney for healthcare is a document that appoints a trusted individual to make medical decisions on your behalf if you cannot do so. This agent is authorized to speak with doctors, review medical records, and consent to or refuse treatment according to the instructions you provide and the agent’s judgment about your best interests. The durable nature of the authority means it remains in effect even if you lose the ability to make decisions. Selecting the right person and clearly communicating your goals to them are important steps in this process.
Living Will
A living will is a specific type of advance directive that documents preferences about life-sustaining treatments in scenarios such as terminal illness or permanent unconsciousness. It can state whether you wish to receive interventions like mechanical ventilation, artificial nutrition, or cardiopulmonary resuscitation in defined medical situations. A living will serves as written guidance for healthcare teams and can help ensure your decisions about end-of-life care are followed when you are not able to communicate them yourself. Regular review is recommended to keep the document aligned with your wishes.
Capacity and Consent
Capacity refers to an individual’s ability to understand relevant information and make informed decisions about medical care; consent is the voluntary agreement to a proposed treatment by someone with capacity. If capacity is lost, the healthcare agent designated in an advance directive typically steps in to decide based on the documented wishes or the patient’s best interests. Assessments of capacity are performed by medical professionals, and clear directives and agent appointments streamline decision-making processes during times when capacity is impaired.
Comparing Limited Documents and Comprehensive Planning
When planning for future healthcare, individuals can choose narrowly focused documents like a simple living will or pursue comprehensive planning that combines several tools. A limited document may address one specific issue, such as resuscitation preferences, while a comprehensive approach coordinates a living will, a durable power of attorney for healthcare, and accompanying estate planning measures. Each option has benefits depending on the person’s circumstances. Careful comparison helps determine whether a single directive will suffice or whether a more complete set of documents is preferable to ensure cohesive decision making and clear guidance for family and care teams.
When a Focused Directive May Be Appropriate:
Clear Specific Preference
A limited approach can be appropriate when a person has a clear, narrow preference about a specific medical intervention and little need for broader decision-making guidance. For example, someone may want to document a firm stance on resuscitation or mechanical ventilation without addressing other scenarios. In such cases, a short living will or single-form directive may provide sufficient direction to medical staff. Even when using a limited document, it remains important to ensure the wording is valid under Tennessee rules and that loved ones and providers are aware of where to find the document and how to interpret its instructions.
Simple, Unchanging Wishes
A limited directive may work well when wishes are simple and unlikely to change over time. If medical preferences are straightforward and there is high confidence in the appointed decision maker or absence of anticipated family disagreement, a concise document might be all that is needed. However, even simple wishes benefit from clear language and proper witnessing to prevent disputes. Ensuring the document is accessible to healthcare providers and that your decision maker understands and supports your instructions helps this focused approach function effectively when medical decisions arise.
Why a Coordinated, Comprehensive Plan Often Works Better:
Multiple Interacting Decisions
A comprehensive approach is often advisable when medical decisions touch on multiple issues that interact with estate planning and caregiver responsibilities. For instance, coordinating an advance directive with powers of attorney, guardianship planning, and wills reduces the chance of conflicting instructions or gaps in authority. This approach helps ensure that medical choices align with broader financial and legal arrangements, providing a coordinated framework that protects the person’s welfare and reduces administrative burdens for family members during stressful periods.
Higher Risk of Dispute or Complex Family Dynamics
When family relationships are complex or there is a higher chance of disagreement about care decisions, a comprehensive plan offers clearer guidance and legal authority to prevent disputes. Drafting detailed directives, appointing a capable healthcare agent, and documenting intent in multiple documents can reduce uncertainty and support smoother decision making. A thorough review of all related legal documents ensures consistency across treatment preferences, financial powers, and end-of-life wishes, which can be especially valuable for people who want to minimize the potential for conflict or confusion among loved ones.
Benefits of Taking a Comprehensive Approach to Healthcare Directives
A comprehensive approach ensures that advance directives, durable powers, and related planning documents work together to reflect a person’s goals and protect their interests. This coordinated planning reduces the risk of contradictory instructions, clarifies who has authority to make decisions, and makes it easier for providers to locate and rely on valid documentation. By aligning medical directives with financial powers and estate plans, individuals can create a consistent set of instructions that guide both care and administrative matters if they become incapacitated.
Comprehensive planning also supports family members by reducing emotional and administrative burdens during crises. Clear, well-drafted documents help avoid delays in care and limit the need for court involvement to appoint decision makers. This approach protects personal dignity by ensuring treatment aligns with the individual’s values and provides a practical roadmap for loved ones facing difficult choices. For many people in Monteagle and surrounding areas, investing time in coordinated planning offers lasting peace of mind and smoother transitions when health changes occur.
Clear Decision Authority
One primary advantage of a comprehensive plan is clear decision authority, which prevents disputes about who should act when medical choices are necessary. Naming a healthcare agent with a durable power of attorney and documenting specific treatment preferences reduces ambiguity and empowers the person chosen to represent your wishes reliably. This clarity helps medical teams make timely decisions, supports consistent application of your instructions, and protects family members from the stress of determining what you would have wanted under uncertain circumstances.
Consistency Across Legal Documents
Comprehensive planning ensures consistency between healthcare directives and other estate documents, preventing contradictory language and unintended outcomes. When wills, powers of attorney, and advance directives are coordinated, decisions about medical care, finances, and end-of-life arrangements follow a unified plan. This reduces administrative confusion, shortens the time needed to implement wishes, and helps family members and professionals carry out responsibilities with confidence. Periodic review of all documents maintains alignment as circumstances and preferences evolve.
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Pro Tips for Advance Healthcare Directives and Living Wills
Choose and prepare your healthcare agent carefully
Selecting a healthcare agent requires thoughtful conversation about values and preferences for medical care. Choose someone who understands your priorities, communicates well with family, and is willing to carry out difficult decisions when needed. Discuss specific scenarios such as resuscitation, mechanical support, and comfort care so the agent knows your preferences. Provide copies of your directive to the agent and medical providers, and review documents together periodically to confirm that instructions reflect your current wishes and circumstances.
Use clear, concise language and meet formal requirements
Share your decisions with family and medical providers
Openly communicating your wishes reduces surprises during medical crises and helps family members support your choices. Explain why certain treatments are acceptable or unacceptable, and provide context for your values. Inform your primary care physician and hospital of the location of your directive and consider including a summary in your medical record. When loved ones understand your priorities in advance, they can better honor your decisions and reduce the burden of making emergency choices without guidance.
Reasons to Create an Advance Healthcare Directive or Living Will
People create advance directives and living wills for many reasons, including the desire to control medical decisions, reduce family stress, and ensure care aligns with personal values. Preparing documents ahead of time avoids uncertainty if sudden illness or incapacity occurs, and appointing a trusted agent provides a clear path for decision making. These measures protect autonomy, help preserve dignity, and assist medical providers in delivering care consistent with the patient’s goals. For residents of Monteagle, documenting preferences under Tennessee law supports local hospitals and caregivers in following your instructions.
Many individuals also use advance directives as part of broader planning that addresses financial and legal matters. Coordinating healthcare directives with powers of attorney and estate documents ensures a unified approach to both medical and administrative responsibilities. This planning can prevent court involvement to appoint a decision maker and minimize conflict among family members. Regular reviews and updates keep documents current with evolving medical options and personal priorities, helping to ensure your arrangements remain meaningful and actionable over time.
Common Situations Where Advance Directives Are Beneficial
Advance directives are beneficial in a variety of situations, including progressive illness, advanced age, planned surgeries, or chronic conditions that could impair decision making. They are also useful for anyone who wants to record clear treatment preferences regardless of current health. Documents are helpful when family members live apart, when family relationships are complex, or when there is concern about future incapacity. Having directives in place ensures that your wishes guide medical decisions and decreases the likelihood of disagreement or delay when urgent choices must be made.
Planned Major Medical Procedures
When undergoing major surgery or invasive treatment, having directives in place provides clear instructions should complications arise that impact decision-making capacity. Documents prepared in advance guide surgeons and care teams, outline acceptable interventions, and designate who will make health decisions if you are unable to do so. This reduces stress for loved ones and helps medical staff honor your preferences without delay, improving communication during the perioperative period and beyond.
Chronic or Progressive Illness
Individuals with chronic or progressive conditions benefit from documenting preferences about long-term care, life support, and comfort measures. Advance directives allow for planning around possible future changes in health, clarifying when certain interventions should be used or withheld. Early discussions and written instructions support consistent decision making over the course of an illness, helping family members and clinicians apply your expressed values during critical moments and reducing uncertainty when symptoms advance.
Advanced Age and Cognitive Decline
Older adults often consider advance directives to address potential cognitive decline that could affect decision making. Preparing documents while capacity remains intact ensures that wishes about medical care, resuscitation, and long-term supports are documented and can be followed. Appointing a healthcare agent and reviewing the directive with family helps promote understanding and reduces the likelihood of contested decisions, creating a framework for preserving autonomy and dignity as health needs evolve.
Local Monteagle Healthcare Directive and Living Will Services
Jay Johnson Law Firm provides local services to Monteagle and Marion County residents who need help preparing advance healthcare directives and living wills. We offer practical guidance on drafting documents that reflect personal values and comply with Tennessee requirements, advise on selecting a healthcare agent, and explain how directives work with other plans. Our goal is to make the process clear and manageable, helping clients document their medical preferences and ensure loved ones and medical providers have the necessary information when decisions arise.
Why Monteagle Residents Trust Jay Johnson Law Firm for Advance Directives
Clients choose Jay Johnson Law Firm for straightforward, reliable assistance with advance healthcare directives and living wills because the firm focuses on clear communication and practical planning. We help translate personal wishes into documents that meet Tennessee legal requirements and are easy for family members and healthcare providers to understand. Our process emphasizes listening to each client’s priorities, making sure the appointed decision maker understands their role, and confirming that documents are executed properly and distributed to appropriate parties.
The firm provides personalized support at every step, from initial conversations about values and treatment preferences to finalizing signed documents and coordinating delivery to medical providers. Clients receive guidance on storage, updates, and how to integrate directives with other estate planning documents. This approach helps reduce the burden on loved ones and increases the likelihood that medical care aligns with the client’s intentions, creating greater peace of mind for the individual and their family.
Contacting the firm is straightforward: call 731-206-9700 to discuss advance directive planning for yourself or a family member. We serve residents across Marion County and nearby Tennessee communities, offering clear options tailored to each person’s circumstances. Whether creating a first directive, updating an existing document, or coordinating a comprehensive plan, our goal is to provide practical help that makes it easier to document and preserve your healthcare preferences.
Ready to Document Your Healthcare Wishes? Contact Us Today
How We Handle Advance Directive and Living Will Matters
Our process begins with a discussion of your goals and values to understand what matters most for your medical care. We then draft documents tailored to your preferences, explain the legal formalities required in Tennessee, and review the completed forms with you and your chosen healthcare agent. Once signed and witnessed according to state rules, we provide guidance on distribution to family members and medical providers and advise on how to keep documents current with changing circumstances. This step-by-step approach helps ensure your wishes are documented and accessible when needed.
Step One — Initial Consultation and Goal Setting
The first step involves an in-depth conversation about your healthcare values, prior medical experiences, and specific preferences for treatment. During this consultation we explore scenarios such as terminal illness, permanent unconsciousness, and severe cognitive impairment to determine which directives are appropriate. We identify a suitable healthcare agent together and discuss the powers you wish to grant. This foundation ensures that the resulting documents reflect your intentions and provides clarity for subsequent drafting and execution.
Discussing Values and Medical Preferences
In this phase we probe the considerations that guide your medical decisions, including pain management, quality of life, and acceptable interventions. These conversations clarify which treatments you would accept or decline and help shape clear, actionable language for the directive. Talking through specific scenarios ensures that the directive addresses likely situations and communicates your priorities in terms that doctors and family members can apply.
Choosing a Healthcare Agent and Backup
Selecting a healthcare agent is a critical decision; we discuss candidates who are available, trustworthy, and able to communicate effectively with medical teams. It is wise to name a primary agent and one or more backups in case the first choice cannot serve. We also advise on what guidance to provide the agent and how to ensure they are prepared to make decisions consistent with your documented wishes.
Step Two — Drafting and Review of Documents
Once goals are clear, we draft advance directives and related documents that reflect your preferences in precise language consistent with Tennessee rules. We review drafts together, clarifying terms and adjusting language to avoid ambiguity. The review process ensures that the documents express your intent accurately and that you and your agent understand how to use them. We also discuss storage, distribution, and how to update the documents over time to remain current with changing circumstances.
Tailoring Language to Your Wishes
Drafting focuses on plain, specific wording to reduce interpretation disputes. We incorporate your stated preferences and address foreseeable medical circumstances where guidance is needed. Careful wording helps healthcare providers and family members apply the directive consistently and reduces the need for legal intervention. This stage includes preparing any related documentation such as durable powers of attorney for healthcare or living wills that work in tandem.
Legal Formalities and Execution
We explain and complete the formalities required under Tennessee law, including appropriate witnessing or notarization, to ensure the documents are valid and enforceable. We also provide signed copies and advise on who should receive them, including your agent and primary care provider. Proper execution and distribution of documents increases the likelihood they will be accessible and followed when decisions must be made.
Step Three — Ongoing Review and Updates
After execution, we recommend regular reviews of your advance directives to account for life changes, new medical developments, or shifts in personal preferences. Updates can be made to reflect altered wishes, a change in your chosen agent, or legal adjustments. Maintaining current documents and notifying relevant parties of changes helps ensure continuity of care and preserves the integrity of your instructions over time.
Periodic Check-Ins and Revisions
Periodic check-ins are an opportunity to confirm that your directives still match your goals and to revise any language that may cause confusion. We can assist with formal amendments or replacements of older documents, advise on how to revoke previous versions, and provide recommendations for distributing updated copies to family and providers. Keeping the documents aligned with current wishes reduces the potential for disagreement or misapplication.
Coordinating with Other Estate Documents
We also help coordinate advance directives with related estate planning documents so that your medical instructions and financial arrangements work together. This coordination reduces inconsistencies across your legal papers, simplifies administration for your loved ones, and helps ensure your overall plan functions smoothly. Periodic reviews of the complete plan maintain cohesion between healthcare preferences and broader legal and financial decisions.
Frequently Asked Questions About Advance Healthcare Directives and Living Wills
What is the difference between an advance directive and a living will?
An advance directive is a broad term for legal documents that record your medical preferences and designate a decision maker if you are unable to communicate. A living will is a type of advance directive that focuses on end-of-life care and specifies whether to use or withhold certain life-sustaining treatments under defined medical conditions. Together, these documents ensure that your wishes about medical treatment are documented and accessible to healthcare providers and family members. Having both a living will and a durable power of attorney for healthcare provides written guidance and a designated agent to act on your behalf. This combination reduces ambiguity and helps medical teams implement care that reflects your values, while giving a trusted person authority to speak for you when required.
Who should I appoint as my healthcare agent?
Appoint a healthcare agent who understands your values, communicates calmly with others, and is available to make decisions when needed. The person should be someone you trust to follow your written instructions and to advocate for your preferences with medical staff and family members. It is helpful to choose someone who can remain composed under pressure and who is willing to accept the responsibilities that accompany decision-making on another person’s behalf. Consider naming an alternate agent in case your first choice is unavailable, and discuss your preferences with the chosen individuals so they understand your wishes. Providing them with copies of the directive and reviewing potential scenarios together will help prepare them to act consistently with your instructions when the time comes.
How do I make sure my directive is followed by medical providers?
To increase the chances that your directive will be followed, use clear language, comply with Tennessee execution requirements, and provide copies to your healthcare agent, primary care physician, and local hospital. Inform family members and caregivers about the existence and location of the document, and consider placing a copy in your medical record or using state registries if available. Clear documentation and broad distribution make it easier for providers to locate and rely on your instructions when decisions are urgent. Regularly review and update the directive to reflect current wishes, and ensure your appointed agent knows where to find the signed original. When medical teams and family members are aware of your preferences and have access to the directive, they can act quickly and consistently in accordance with your documented instructions.
Do advance directives need to be notarized in Tennessee?
Tennessee law has specific requirements regarding signatures and witnessing for certain types of advance directives, and following those formalities helps ensure validity. While some documents benefit from notarization, others require the presence of witnesses. It is important to follow the prescribed execution steps and to include the required attestation statements so that medical providers recognize the document as legally effective under state rules. Working with a knowledgeable attorney or legal resource can help you complete the proper formalities and avoid common mistakes. Ensuring witnesses meet any statutory qualifications and that signatures are properly dated reduces the risk of a directive being challenged or rejected at a critical time.
Can I change or revoke my advance directive after it is signed?
You can change or revoke your advance directive at any time while you have capacity to do so. Revisions should be made in writing and follow the same formalities as the original document where required, and you should inform your healthcare agent and medical providers of any updates. Destroying the old document and replacing it with a newly executed version is a common approach to avoid confusion about which document is current. If you revoke a directive, notify relevant parties, update medical records, and provide copies of the new document to your agent and care team. Clear communication about changes helps ensure that your current wishes are respected and that outdated instructions are not mistakenly followed.
What if family members disagree with my documented choices?
If family members disagree with your documented choices, a clear, well-executed directive and a designated healthcare agent can reduce the chance of disputes. Courts may become involved when disagreements are unresolved, which can delay decision making and increase emotional strain. To prevent conflict, communicate your wishes in advance with family members, explain the reasons behind your choices, and ensure that your agent and medical providers have access to the signed directive. If disagreements arise despite proper documentation, seeking prompt legal guidance can help clarify legal authority and next steps. Documentation that meets Tennessee requirements and a named agent with clear authority typically provide the strongest protection against family conflict.
Should an advance directive be included with my other estate planning documents?
Including your advance directive with other estate planning documents promotes a cohesive plan and helps ensure that medical instructions and financial powers work together. Coordinating directives with your will, powers of attorney, and beneficiary designations reduces the risk of inconsistent instructions and provides a single framework for your legal and healthcare decisions. This coordination also helps family members and appointed agents understand their responsibilities across different matters. When documents are aligned, transitions are smoother and the likelihood of confusion is reduced. Regularly reviewing the entire set of documents after life changes helps maintain consistency and ensures that all components of your plan remain relevant and effective.
How often should I review or update my living will?
Review your living will and advance directive periodically and after major life events such as a change in health, the death of an appointed agent, marriage, divorce, or relocation. Medical technology and personal preferences can evolve over time, so updating directives ensures they continue to reflect your current values. A periodic review every few years is a practical way to confirm that documents remain aligned with your wishes. When you revise documents, follow proper execution steps and distribute updated copies to your agent, family, and healthcare providers. Keeping records current prevents misunderstandings and ensures your most recent instructions guide care decisions when they become necessary.
Will my advance directive work if I get care outside Tennessee?
Advance directives created in Tennessee generally inform care anywhere, but acceptance can vary by state and by specific facility policies. Many providers and institutions will honor a properly executed directive from another state, particularly if the document is clear and names a decision maker. When traveling or relocating, it is wise to review whether additional steps are recommended to ensure your directive will be recognized in the new jurisdiction. If you expect to receive care outside Tennessee, consider discussing portability with a local legal resource and, if needed, execute a directive in the other state or carry supplemental documentation. Sharing copies with medical providers and your agent helps maintain continuity of care across state lines.
How do I start the process of creating an advance directive or living will?
Begin the process by reflecting on your medical values and discussing preferences with loved ones and potential decision makers. Gather basic health information and consider scenarios where you would want specific interventions or comfort-focused care. Contact Jay Johnson Law Firm at 731-206-9700 to schedule a consultation where we will explain the options, recommend the appropriate forms, and guide you through execution steps that comply with Tennessee law. During the appointment we will help you choose an agent, draft clear language for the directive, and complete any witnessing or notarization required. We also advise on distribution and how to incorporate the directive into your broader estate planning to ensure coherence and accessibility when decisions arise.