Advance Directives and Medical Power of Attorney

Life is full of uncertainty. You never know when you are going to need an advance directive. These directives dictate what your medical teams should do with you if you’re not in the state to make a decision. It’s an important tool as well that might save your family tons of fortune on unnecessary medical expenses, [1] among other things.

There are two primary kinds of advance directives:

  • A living will spells out your preferences about certain kinds of life-sustaining treatments. For example, you can indicate whether you do or do not want interventions.  This also includes cardiac resuscitation, tube feeding, and mechanical respiration as well.
  • A power of attorney directive names someone that you trust to act as your agent if you are unable to speak for yourself. You can also do separate financial and health care powers of attorney. You can choose one person to speak for you on health care matters and also someone else to make financial decisions,.

A power of attorney is more flexible by nature, as it has to deal with more uncertainties. You never know what you are going to be struck with that render you in the state that makes you unable to make a decision. Be sure that you are entrusting the power of attorney to someone who you trust. Also choose someone who does not benefit from your state.

Many states actually combine the living will and power of attorney into one "advance directive" form. 

Thinking About a Living Will

There are specific conditions that you should include in your medical power of attorney. This will guide the action of your medical staffs to comply with your wishes. You might want to include things like:

  • Do you want all pain relief options available, even if they may have the side effect of unintentionally hastening your death?
  • Which life-sustaining options -- such as tube feeding, mechanical ventilation, CPR, and antibiotics -- do you want, and which would you not want? How long would you want these options to be continued if your condition is not improving?
  • Would you want artificial life support removed if you are found to be irreversibly brain dead? Do you prefer that your life be sustained until your heart stops on its own?
  • What are your feelings about organ donation?
  • How do you want your body to be disposed of after death? (Burial, cremation, medical research?) Which funeral home or other organization do you want to handle the arrangements?

Every state has its own form of advance directives. Answering these questions and including specific conditions that you want in yours is important. It will allow you to adjust your demands to the laws of that state. This will ensure that you put yourself in the exact situation you’ve assigned, if the case does come to pass. You can always add [2] or change the clauses of your advance directives. That is if you change your mind in the future, or if the circumstances demand it.


References:

1. Lubitz, J; Riley, GF. Trends in Medicare payments in the last year of life. New England Journal of Medicine. 1993;328:1092-1096.

2. “Advance Care Planning: Healthcare Directives.” National Institute on Aging, U.S. Department of Health and Human Services, www.nia.nih.gov/health/advance-care-planning-healthcare-directives.


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