Advance Health Care Directive

Advance Health Care Directives Explained

Living wills and advance directives define your desires for your end-of-life care. These documents speak for you when you are no longer able to speak for yourself.

Power of Attorney

A medical or health care power of attorney is an advance directive in which you designate a person to make decisions for you when you are incapacitated or otherwise unable to do so. The person you name as your power of attorney may be a spouse, another family member, friend or member of a faith community; essentially, your power of attorney should be someone who will always follow your directives and have your best interest at heart. As with trust administration, you may want to choose one or more alternatives in the event that the person you initially chose is unable to fulfill his or her role. It should be noted that in some states this directive may also be called a durable power of attorney for health care or a health care proxy. Depending on where you live, the person you choose to make decisions may given the following titles:

Health care agent
Health care proxy
Health care surrogate
Health care representative
Health care attorney-in-fact
Patient advocate

It is essential to choose the right person to act as your health care agent. Not all medical situations can be anticipated and some situations will require someone to make a judgment about your desired care, as legal documents regarding your medical wishes may not account for every contingency. You should choose a person who meets the following criteria:

A person who meets your state’s minimum legal requirements for a health care agent
A person who is not your doctor or a part of your medical care team
A person who is willing and able to discuss your medical care and sensitive end-of-life issues with you
A person who can be trusted to make decisions that are in line with your wishes and values
A person who can be trusted to be your advocate if there are disagreements about your care

A Living Will

A living will is a written legal document that spells out any and all medical treatments you would or would not want to be used to keep you alive. Living wills may also provide specific guidance on other decisions such as pain management, the use of life support systems, or organ donation. In determining your wishes, consider your values:

How important is self-sufficiency and independence to your overall well being?
What circumstances would make you feel as if life were not worth living?
Would you want treatment to extend life in any situation?
Would you want treatment only if a cure is possible?

Discuss your personal medical wishes with your primary care doctor, your health care agent, family and friends to ensure that all parties are on the same page when it comes to your medical care or end-of-life decisions. You should address a number of possible end-of-life care decisions in your living will, including:

Resuscitation
Mechanical intervention
Tube feeding
Dialysis
Antibiotics or antiviral medications
Comfort or palliative care
Organ and tissue donations
Donating your body to science, etc.

More on Advance Directives

Advance directives are legally binding documents throughout the United States. In fact, you do not need a lawyer to complete advance directives, as any advance directive created becomes legally valid as soon as it is signed in front of the required witnesses. However, the laws governing advance directives and their implementation can vary widely from state to state, so it is important to complete and sign advance directives that comply with your state’s specific laws. Additionally, it should be noted that advance directives may have different titles in different states.

Unfortunately, one state’s advance directive does not always work in a different or even neighboring state. Some states do honor advance directives from other states, while others will honor out-of-state advance directives as long as those directives are similar to the state’s own law. However, some states do not have definitive laws regarding the honoring of out-of-state directives, so they may not honor yours. If you spend a significant amount of time in more than one state, it is recommended that you complete advance directives for each state.

More importantly, advance directives do not expire. Once written, an advance directive remains in effect until you change it, with the completion of a new advance directive invalidating all previous iterations of the document. With that in mind, you should review your advance directives periodically to ensure that they still reflect your wishes. Once completed, you must create a whole new advance directive if you wish to change any single part of the document. We are here to answer any questions you may have, call us at (818) 360-9500.