There are two primary legal documents used to address heath care decisions and decision making; an Advanced Directive–also known as a Living Will, and a Durable Health Care Power of Attorney. In these documents, you express your choices about the types of medical care you do and do not want to receive during your lifetime and at the end of your life, in case you are unable to make these decisions for yourself at that time. Sometimes these are combined into a single document, but each one has a different focus. As long as you have the capacity to make decisions for yourself, you can change your choices in the documents, at any time. For most people, it is helpful to speak with your medical professional to be sure you understand the implications of accepting, limiting, or refusing medical treatment in specific medical situations. If you are a client of Keystone Elder Law, our attorneys can help you customize these documents to your particular situation.
Durable Health Care Power of Attorney
With this document you designate one or more persons as your Agent to make health care decisions for you when, and only when, you are unable to make them yourself. These decisions may include authorizing medical treatment, admissions to medical facilities, refusing medical treatment, or hiring and discharging medical professionals. In addition, the document authorizes your Agent to have access your private medical information so he or she can help you make your own decisions. This is an extremely important part of the document as a result of the HIPPA medical privacy rules. It is important to discuss your preferences for treatment with the person(s) you designate as your health care Agent, so he or she will know how to represent you. It is also important for your health care Agent to have access to a copy of the document, since you never know when it may be needed.
This document applies only in two specific situations: if you have an end stage, terminal medical condition, or if you are in a permanent state of unconsciousness. In Pennsylvania a physician must verify you are in one of these two medical situations before your Living Will can go into effect. Commonly, the Living Will takes effect at the time Hospice can be involved in your care. In your Living Will you can state how aggressively you wish to be medically treated or you can state your wishes to decline treatment if such treatment would only prolong the process of your passing. You may also designate a Surrogate to clarify on your behalf any treatment questions medical professionals may have once your Living Will is active. If you designate a Surrogate, you should discuss your preferences with him or her so he or she knows what you would choose to do if you were able to make the decision for yourself. Finally, your Living Will allows you to specify any anatomical donation (i.e. organ donation) you would like to make after you are deceased. It is important to remember when completing a Living Will that there are no right or wrong decisions; the document is to reflect your personal wishes. If you complete a Living Will, you should give copies to those individuals who would be contacted should you become hospitalized. Because a Living Will only applies to end of life health care decisions, we strongly recommend you have both a Living Will and a Durable Health Care Power of Attorney to properly address your medical treatment decisions in all circumstances.
As long as a patient has the capacity to make his or her own decisions, he or she has the right to accept, limit, or refuse any recommended medical treatment. Some individuals when they are hospitalized do not want to be resuscitated should they suffer an unexpected cardiac or pulmonary arrest. To exercise their right not to be resuscitated they need to speak with their attending physician upon admission and ask for appropriate orders to be placed in their medical record. This process is not part of the Living Will or Durable Health Care Power of Attorney and must be done upon every hospital admission.