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The Seriousness Of It All: Advanced Heath Care Directives.

By John Dietz - Email Editor

Date : June 23, 2008

Dear Valued Reader,

Being the CEO of your household can be a daunting task. Most of the day to day decisions are based on life activities. Seldom do we talk or wish to talk about adverse medical conditions that can afflict and affect the family home. Today we are dealing with medical powers. Before rolling your eyes and yawning, consider that most people do not have Advanced Health Care Directives, Medical Power of Attorney and/or a Living Will in place.  Most surveys reveal that over half of the population has not dealt with this subject, and the ones that have need a check up.

Nearly everyone is aware of the terms such as Living Wills or Medical Power of Attorney from the televised reports on cases in the media where there is a battle over who has the power to decide to end life support (such as the Terry Schiavo case). These kind of situations were the beginning incentives for state legislators to pass laws recognizing Living Wills. From there the Health Care Power of Attorney evolved and was used in conjunction with the Living Will. Today, the Advance Directive is now the choice mechanism in many states. And in some states, such as California, the Living Will is no longer statutorily recognized.

There are plenty of cases to recite where people gave authority to a trusted person, and as life scenarios changed, the remaining family became disconcerted with the principal’s choice of Power of Attorney.  This is not to be confused with Powers of Attorney over a will or estate.  Those are separate legal issues and require separate documents.  The case law is not what is important here; your life and your family’s peace of mind is at stake.  Herein lies the seriousness.

Below is just one of many of disclaimers that can be in a Medical Power of Attorney:

Beginning is the hardest part.  The thought of our incapacity is serious and sobering, but it should be faced.  We are the only life-existence on the earth that realizes at some point we will die.  Some say this is a gift, and others say it is a curse, but you have the option to deal with it.  You, as principal, ought to give serious and solemn thought to what you want and what you do not want.  These thoughts will lead you to your own emotional desires, and they will paint the picture as to how you direct others to manage your situation in light of incapacity.  Many decisions have to be made; long-term care, finances, insurance, pending surgeries and life-support are subjects for you and your family to discuss.  You can relieve your family by making these decisions for them, and maybe that is a gift.

Advanced Directives need to be reviewed regularly, since many conditions change just as medical care and technology advances.  Your Advanced Directives generally must be authorized by your appointed agent – not the Emergency Medical Technicians.  The Medical Power of Attorney may contain separate clauses with physician’s directives for specific circumstances. 

A Medical Power of Attorney may be generally be revoked by notifying either the agent or the principal's health care provider, orally or in writing, or a writing of the principal's intent to revoke. This revocation will occur regardless of the principal's capacity to make health care decisions. Further, if the principal executes a later Medical Power of Attorney, then all prior ones are revoked. If the principal designates his/her spouse to be the agent, then a subsequent divorce revokes the Medical Power of Attorney.  The agent must sign a disclosure stating that they have read and understand the responsibility of the Medical Power of Attorney.

The subject of the law regarding the cessation of life support is an area of discussion for another newsletter.  For now, it would suffice to say that when dealing with Advanced Directives and Medical Power of Attorney, a person should be very clear about their intentions in the event that there is a dispute and a judge has to interpret the principal’s desires according to the wishes of the individual.

I find it interesting that end times are often discussed in the religious community as part and parcel of the education for understanding the mysteries of life and death; however the individual is not so-inclined or not so self-reflective on their own end time. This rather obvious weakness of our human condition can cause the family members much stress and consternation resulting in decisions you may not agree with. Therefore, you would be well served to spend some quiet time to sort out your affairs.

We are certainly here to advise if you ascertain that you need help.
 

Until next time,
 
John

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