WHAT DO YOU WANT YOUR DOCTOR TO DO AT THE END OF YOUR LIFE?
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 you can use 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 or she can take instructions from.
Fortunately my friend, who made a full recovery, did not need to use the second document, an Advance Directive (sometimes called a "Living Will” or Directive to Physicians). 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. You should give a copy of the directive 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 different physicians make different recommendations.
A third document, which in Clark County you get from your physician rather than your attorney, is an Emergency Medical Services-No CPR Directive, which asks that emergency medical personnel not revive you. While you should sign your Health Care Power of Attorney and your Health Care Directive well before a medical crisis, the Emergency Medical Services-No CPR Directive is something you obtain from your doctor toward the end of your life.
Making decisions about what you would want done, health care-wise, at the end of your life is difficult. However, if you get your instructions in writing ahead of time, you can make a crisis less stressful for your family.
Elizabeth A. Perry has been helping Clark County residents with their estate planning and probate needs since 1976. She is a frequent seminar speaker. Her practice emphasizes guardianships, probate, Medicaid issues, wills, trusts, incapacity issues and durable powers of attorney. Phone: (360) 816-2485 Fax: (360) 816-2486
(The above should not be construed as specific legal advice and is intended for general information purposes only.)
