Medical knowledge and technology have advanced significantly in recent years increasing the ability to sustain lives thus expanding the human lifespan. In advanced age or poor health, we may find ourselves in a position where decisions need to be made as to how we wish to be medically treated in certain situations. This is especially true at the end stages of life when we may be unable to express our preferences about treatment and critical health decisions are being made by others. This current Weekly Pulse article discusses the importance of using a Living Will and Health Care Proxy to dictate the type of medical care you want should you be unable to articulate your wishes.
Let us begin with the Living Will also known as Advance Directive. This is a written document which outlines your health care wishes for end-of-life care if you become terminally ill and cannot make decisions on your own. It tells your medical providers the types of treatments you may or may not want including how long you want your life prolonged. It can also include religious preferences. A Living Will does not impact your current medical treatment. Consider your value when determining your wishes, how important it is to you to be independent and self sufficient? Identify what circumstances might make you feel like life is not worth living. Would you want treatment to extend your life or to not be resuscitated? Would you want treatment only if a cure is possible?
A Living Will is one way to communicate your values and beliefs, but the language used in a standard Living Wills can often be too narrow to be useful in many common medical situations. Depending on state law, this document may permit you to express whether you wish to be given life-sustaining treatments in the event you are terminally ill or injured. A Living Will can be terminated at any time, but some states may require a renewal after a certain number of years this can vary. If you spend time between two or more states, be sure to review the laws of each state and speak to your health care provider. Be very careful signing any such document without reviewing the possible implications to you. Be certain that whatever you sign is consistent with your beliefs and wishes.
A Health Care Proxy sometimes called a “Health Care Surrogate”, or “Durable Medical Power of Attorney” is a durable power of attorney specifically designed to cover medical treatment. It is a legal document that appoints a person you trust to express your wishes and make medical decisions for you when you are unable to do so. Even if you have a Living Will in place, you should still have a healthcare proxy. Not all medical situations can be anticipated, and you never know when you may need someone you trust to make a judgment call about your health care wishes. The person you choose may be a spouse, family member, friend or some other person you are close to and trust.
The main responsibilities of a Health Care Proxy are as follows:
- Conferring with the medical team and reviewing the medical chart
- Discussing treatment options
- Requesting consultations and second opinions
- Consenting to or refusing medical tests or treatments
- Making life-support decisions
- Authorizing transfer to another physician or institution.
You would appoint a person and grant to him/her the authority to make medical decisions for you in the event you are unable to express your preferences about medical treatment. Most commonly, this situation occurs either because you are unconscious or because your mental state is such that you do not have the legal capacity to make your own decisions. Normally, one person is appointed as your health care proxy. It is quite common, however, for you to appoint one or more alternate persons (successors) in the event your first-choice proxy is unavailable. You should confirm prior to appointing someone as your proxy that he or she will in fact be willing and able to carry out your wishes.
Choosing a Health Care Proxy when choosing a person to be your health care agent, you want to make sure of the following:
- Your Proxy is 18 or older.
- You feel comfortable speaking openly and honestly with this person about your wishes.
- You can have several discussions with your health care agent over time, in case your wishes, values or medical needs change.
- You believe the person you choose is comfortable taking on the role of health care agent, able to make difficult decisions and able to stand up for your rights and wishes.
- You know the person you choose will be able to carry out your wishes regardless of their values, religious beliefs, love for you and other family members’ beliefs.
- You choose someone who lives locally or can be reached easily in case of an emergency.
Many people prefer to keep their legal documents private with end-of-life issues, however, communicating your wishes is essential. An Advance Health Care directive is the first step in this process. However, you need to discuss your preferences with others. Take the time to discuss these issues with the person you appoint as your Health Care Proxy. Make sure your family knows how you feel about end-of-life issues. While conversations are no doubt difficult, they will relieve those you appoint of tremendous emotional burdens by your having personally explained your desires. When it comes to drafting a HealthCare Proxy or a Living Will, The Law Offices of Marjory Cajoux will be with you every step of the way. We have helped families with a range of elder law issues, including estate planning, Medicaid planning and more.
