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 End
Of Life Medical Decisions
Your Will contains your instructions for the distribution of your
possessions after your death. More important are your instructions about
your medical treatment when you can no longer make decisions for yourself.
There are two documents which are used for this type of planning—a Health
Care Power of Attorney and a Health Care Directive. In a Health Care Power
of Attorney you designate someone to be in charge of making decisions about
your health care if you are incapacitated. In a Health Care Directive
(sometimes called a living will) you state that you wish to die a natural
death without being kept alive by artificial means.
As an estate planning attorney, the different documents I prepare for
clients can seem abstract. That changed dramatically for me a few years ago
when I received a call from the hospital emergency room at 11:00 at night. I
had agreed to be the Health Care Power of Attorney for a close friend. She
was single and in her late 30’s so the issue seemed very remote and I did
not think twice when I agreed to do it. However, when the call came from the
emergency room that she was there, unconscious, with a brain aneurism, the
document was no longer something abstract I had studied in law school. By
agreeing to be her Health Care Power of Attorney, I was now involved in life
and death decision making.
Without the Health Care Power of Attorney
I would have had no authority to talk to her doctor. With the Health Care
Power of Attorney he was able to get my authority to perform the testing
needed and she had me there evaluating the pros and cons of different
treatment options. I certainly witnessed how in a crisis it is extremely
beneficial for the doctor to have someone clearly designated that he can
take his instructions from.
Fortunately my friend, who made a full recovery, did not need to use
the second document, a Health Care Directive. In that document you state
that if you are in a terminal and/or permanent unconscious condition that it
is your instruction that life-sustaining treatment be withheld. You need to
sign the directive in the presence of two witnesses. The witnesses cannot be
entitled to your estate or anyone related to you by blood or marriage, nor
can they be your physician or an employee of your physician or your health
facility.
A copy of the directive should be given
to your physician for inclusion in your medical records. Some of the
difficult questions that you will be called on to answer in your Health Care
Directive are whether if you are in a terminal or permanent unconscious
condition, you want artificially provided nutrition and/or hydration. This
is an important issue to talk to your physician about since there are
different schools of thought on that question.
A third document, which in Clark County one gets from one's physician
rather than one' attorney, is an Emergency Medical Services-No CPR
Directive, which asks that emergency medical personnel not revive you. While
the Health Care Power of Attorney and the Health Care Directive are most
often signed well before a medical crisis, the Emergency Medical Services-No
CPR Directive is something people obtain from their doctor toward the end of
their lives.
Making decisions about what you would want done, health care-wise, at
the end of your life is difficult but putting the documents in place, ahead
of time, can make times of crisis a little less painful for your family.
Elizabeth A. Perry is a
shareholder in the Vancouver law firm of Landerholm, Memovich, Lansverk &
Whitesides, Inc., P.S. and has been helping Clark County residents since
1976. Her practice emphasizes estate planning, probate and Medicaid
planning. (The above should not be construed as specific legal advice and is
intended for general information purposes only.)
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