Every few years, a story hits the headlines that highlights the importance of pro-active planning for times of permanent or temporary incapacity. We see families torn apart because opinions differ on how to care for a someone who is receiving medical care and unable to communicate for themselves. These disagreements can be stopped before beginning by naming a Medical Power of Attorney (agent), creating a Directive to Physicians and a Global HIPAA Release. Equally important to creating these documents is communicating with those named as agents regarding their duty and responsibility as an agent.
Let’s first start with a primer on what each document listed above accomplishes.
- Medical Power of Attorney allows an agent to make medical decisions for the principal should the principal be unable to communicate with physicians.
- Directive to Physicians (aka living will) proactively tells doctors if the principal wants to receive artificial life support like breathing machines. Note: A Directive to Physicians is not the same as a DNR. A DNR is much more draconian in action by excluding assistance such as CPR.
- Global HIPAA Release permits a Medical Power of Attorney to talk with all doctors (present or past) in order to make well- informed medical decisions on behalf of the principal.
The overarching duty and responsibility of a Medical Power of Attorney (agent) is to make medical decisions, up-to and including, removal from life support should the principal be unable to communicate for him or herself. There is a lot of responsibility packed into that short sentence.
Communication between the agent and the principal BEFORE crisis time is of paramount importance so that the principal’s wishes are thoroughly understood. Very few like talking about times of illness or medical emergency, but the benefit of having such a frank conversation outweighs the potential emotional distress later. Here are some tips on what to talk about.
- Medical history: are there any past medical conditions or treatments that an agent should be made aware?
- Treatments for terminal or irreversible conditions (and the differences between the two conditions):
- Terminal condition: a diagnosis from which the agent is expected to die within 6 months.
- Irreversible condition: a diagnosis that prevents the agent from caring for him or herself and is expected to die without life-sustaining treatment.
- Special requests: these should be noted in the Directive to Physician official document as well.
- Are there any spiritual end of life activities requested by the principal?
- Does the principal want the terminal or irreversible condition to be supported by 2 or more doctors?
- Does the principal want loved ones gathered prior to removal from life-support machines?
- Generally, what type of medical treatments does the principal agree to have: CPR, AED paddles, blood transfusions, palliative care but not life extending care, experimental treatments, intravenous antibiotics, etc.?
Talking with the named agent(s) about each of the medical documents is very important so that they clearly understand and have first-hand knowledge of the principal’s wishes regarding medical care. Contact Crain & Wooley if you have questions or concerns regarding naming an agent or being named AS an agent.