Living will and medical power of attorney (medical POA)
Err on the side of caution
Your health is a precious commodity. What you do with that commodity is your business. You decide whether to smoke, exercise, diet, drink alcohol, skydive or race motorcycles. And you decide on your medical treatment if you are hospitalized. Modern medicine is predicated on Informed Consent. No doctor would touch you without it.
Do not live in a fool’s paradise!
But what if you are comatose? On life support? Or suffer dementia? Who decides on treatment when you can no longer communicate effectively? The thing about heart attacks, accidents and COVID-19 is that they strike quickly. One day you are healthy; the next day you are on a ventilator.
Informed consent
Informed consent resides with the patient or, if a patient is incapable of providing it, a chain of vicarious representatives, beginning with signed health care proxies. The attending physician can bypass this chain of representation in a life-threatening emergency, but the dual requirements of an emergency and life-threatening rule out discretion when a patient is, for example, comatose and on life support. In most instances, the hospital is required to care for you as long your body holds out.
Most people recoil at the thought of spending weeks, months or even years in a vegetative state, yet few take the time to declare treatment instructions and preferences on paper. Who should speak on your behalf if you cannot communicate? Which doctors know you best and should be consulted? What medical treatments do you consent to, which ones do you decline? At what point can your legal representative terminate life support?
The topic is harrowing. I know. But if you have strong opinions, now is the time to express them. Spare your family the agony of having to second-guess what you would have wanted, and then having to live with that decision. Give them guidance while you still can, so they are free from regret later, knowing they adhered faithfully to your wishes.
Authorized representatives according to the law
Without a person authorized to represent you, the law regulates who may consent to or refuse medical measures should you be unable to do so or incapacitated. The following persons are empowered, in descending order, to represent a person lacking capacity to consent, and to decide on medical treatment on its behalf:
- The person designated in a patient decree.
- The welfare advocate with powers of representation in medical matters.
- A spouse, living in a common household or regularly and personally assisting a patient.
- Whoever lives with the patient in a common household, and regularly and personally assists.
- Your offspring.
- The parents.
- The siblings.
Living will (aka patient decree, advanced medical directive or advanced health care directive, AHCD)
A Living Will (aka a patient decree, also called an advanced medical directive or advanced health care directive) provides written instructions regarding your medical care. It states your consent to certain procedures and your opposition of others. It can identify preferred medical personnel and preferred places of treatment. It may include a Do Not Resuscitate instruction, or that instruction may be prepared separately.
Do not resuscitate instruction (DNR)
A DNR instructs medical personnel to cease performing life-sustaining treatment such as cardiopulmonary resuscitation (CPR), intubation and defibrillation. Clients use them if they want to stay off life-support in the event of a coma or other serious injury or illness.
Quality of life, dying with dignity
A Living Will requires much thought. Talk to your Health Care Agent and your loved ones about quality of life and end of life matters, about dying with dignity, and about your wishes, beliefs, fears and hopes when faced with illness, aging and death. And put your thoughts in writing.
Organ donation
What is your position on organ donation respectively tissue and organ harvesting, on transplantation? Inform your next of kin so that they are relieved.
Safe storage
Finally, an advance health care directive and medical power of attorney are worthless if no one knows about them, or they cannot be located in time for treatment. Safeguarding sensitive, time-crucial documents is another good reason for retaining a lawyer.
Have you prepared your living will and medical power of attorney? You should. It will assure you and your family peace of mind later. Call me for assistance. I can make the process easy, ensuring that your documents are articulated properly, and enforceable.
Health care proxy (or durable healthcare power of attorney)
As an alternative to a detailed living will, you may designate and appoint a representative. He will make medical decisions on your behalf if you become incapacitated. This is accomplished with a Health Care Proxy (or Durable Healthcare Power of Attorney). In contrast to the advance directive, this applies immediately.
Medical power of attorney (or health care agent)
Who should you appoint as your Medical Power of Attorney (or Health Care Agent)? Choose someone who can act under pressure and understands your wishes. Choose someone you trust to make life and death treatment decisions for you, and who can live with themself after making them. Choose someone whose decisions will be respected by your family.