Thomas H. Sullivan

Attorney at Law



Deeper Dive into Advance Healthcare Directives

Posted on: September 16th, 2020
When it comes to your healthcare, especially during these uncertain times, you need to ensure that two estate planning documents in particular are up to date. The first is your healthcare power of attorney. This document allows you to name a person to make medical decisions on your behalf or communicate your wishes in the event you are unable to. The second document your estate plan should include is an advance healthcare directive, sometimes referred to as a living will. (It’s important to note that in some states, these two documents are combined into a single document.) An advanced healthcare directive clearly spells out your wishes for the end of your life, for example, whether or not you want to be placed on life support if you are in a persistent vegetative state or have a terminal illness. Although it is one of the least discussed documents in an estate plan, it is equally as important as the other documents. When reviewing your advanced healthcare directives, it is crucial that you determine what your wishes are and that you meet with your estate planning attorney to confirm that your advanced healthcare directives adequately reflects those wishes.
 
In addition to meeting with your estate planning attorney, you should have a meaningful discussion with the person you designate to make your healthcare decisions for you in the event you are unable to. Although this conversation will likely be uncomfortable for those involved, as these topics are often difficult to think about, you should discuss the following issues, as well as any others you may think of, to guarantee that you are cared for in the way you want.
 
Do you have particular beliefs about healthcare or end-of-life care?
Consider any spiritual, religious, or personal beliefs you have about your end-of-life care. For example, what are your beliefs about blood transfusions, organ donation, or artificial life support? Do you want clergy or other spiritual or religious leaders at your bedside before you pass away? Consider documenting these beliefs and wishes, perhaps even requiring that your healthcare decision-maker honor them when you cannot speak on your own behalf.
 
What type of medical interventions do you want?
When faced with end-of-life care in which you are not able to communicate your wishes, it is important that your chosen healthcare decision-maker understands the types of treatments you do or do not want administered. Depending on the situation, there could be a variety of treatments or interventions available, such as experimental drugs or procedures, ventilators, feeding tubes, or artificial hydration through an IV. You may want to document your specific wishes on these or other decisions.
 
Do you have different wishes based upon your medical condition or prognosis?
Depending on your state, your advance directives might contain provisions on the care you will receive in either a terminal condition or persistent vegetative state. While advance directives do not memorialize “do not resuscitate” orders (those are done at a hospital and usually with the advice of a physician), you may be able to direct your medical decision-maker (and those treating you) to remove medical interventions and cease medical treatment if you are in a terminal condition, as certified by a physician. Consider also if you have certain wishes regarding the discontinuing of interventions or treatment if you are deemed by physicians to be in an irreversible and persistent vegative state.
 
Will your chosen healthcare decision-maker honor your wishes?
This is one of the most important questions you must ask both yourself and your chosen healthcare decision-maker, and you should have confidence in the answer you receive. While you may be steadfast in your beliefs and decisions about your end-of-life care, if you are unable to communicate this information, someone else will have to make these decisions on your behalf. If the person you have chosen does not agree with you, and absent properly executed documentation of your wishes, your chosen decision-maker will be allowed to make whatever decisions the decision-maker believes are in your best interest. Even if your wishes are properly documented, will your chosen person honor them if that person does not agree with your decisions, or will your decision-maker create an additional roadblock by challenging those decisions in a court of law?
 
If you suspect that the person you have chosen will not honor your wishes, you need to update your medical power of attorney immediately. You cannot predict when you will be in the hospital facing the end of your life, so you need to make sure that your documents are up to date and ready to be used at a moment’s notice.
 
We are here to help you
With healthcare at the top of everyone’s mind right now, we want to reassure you that we are here to help. Choosing the right healthcare decision-maker and clearly communicating your wishes for your end-of-life care are two matters that should not be taken lightly. We can assist you in determining whom to name to this very important role and making sure that your wishes are clearly communicated in the appropriate documents. Give us a call today to schedule an in-person or virtual meeting.

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