“In life the only thing that you can expect is the unexpected; the only surprise is a day that has none.” – Joan Rivers
It’s said that in life, nothing is guaranteed. When it comes to your medical care and distribution of your assets, an advance directive comes close.
There are ways to gain important peace of mind if you need a major medical procedure, are diagnosed with a degenerative disease, or just experience general uncertainty and anxiety about the future.
Though some situations cannot be avoided, legal documents can be employed to clarify your wishes and priorities. If you become debilitated by an illness or injury, an advance directive can detail which treatments and interventions you prefer and whom you would like to communicate with medical professionals on your behalf if you are unable.
Generally, there are two components of an Advance directive:
- Living Will – In a living will, you indicate what treatments you would want to receive or forego, should you become incapacitated.
- Medical Power of Attorney – In a medical power of attorney, you name a representative – called an agent – to speak for you, if you are unable, and determine the type and extent of medical intervention based on your expressed wishes in your Living Will and his or her knowledge of your desires.
An advance medical directive might also state your wishes for organ donation and your funeral wishes.
These documents can work individually or in concert to honor your wishes.
What is a Living Will?
While a last will and testament is used to distribute your assets after death, a living will is utilized while you are still alive – albeit critically ill.
This document is essentially a list of instructions or guidance for your healthcare providers, agents, and loved ones to inform your medical care should you wind up in a position where you are unable to make or communicate medical decisions for yourself. You can specify how and when various interventions can be used or withheld. These interventions might include the use of pain medication, feeding tubes or enteral nutrition, and ventilators.
You can elect to have the document become legally effective upon your incapacity, or effective immediately upon signing it. When drafting a living will, there are procedures that must be followed to render it valid. Some states suggest a template, and once complete, the document must be printed, signed, and witnessed.
Depending on your location, some people may be prohibited from serving as witness – namely friends or family who would gain financially when you pass away. Also, certain healthcare institutions may have policies barring their employees from filling this role.
What is a Medical Power of Attorney?
A medical power of attorney nominates an agent to act in accordance with your known intentions if you are unable to make or communicate your wishes for medical treatment.
Typically, medical powers of attorney are durable, meaning they are valid until revocation or death. A medical power of attorney can be used in case of stroke or aneurysm, complications from anesthesia, accidents causing unconsciousness or coma, and Alzheimer’s disease or other forms of dementia. Your agent should have a clear understanding of your healthcare wishes so that they can act in accordance with those wishes if you are not able to express your wishes.
These choices go beyond treatment received in the hospital. Agents can determine home health interventions, assisted living or nursing home arrangements, which providers are involved in your care, and even authorize modifications to your home to create a safer environment. Given the gravity of an agent’s responsibility, it is essential the agent possesses the judgment needed to navigate complex ethical decisions.
What Document Do I Need – a Living Will or Medical Power of Attorney?
Both! A living will allows you to express your wishes for your care. If you prefer to cede these decisions to someone you trust, you can provide guidance on what defines quality of life for you. A medical power of attorney will appoint the person or persons you want to be your voice when you are unable to advocate for yourself. These documents work together to ensure that if an agent is needed, they understand your wishes.
In Maryland, the document commonly used is referred to as an advance healthcare directive; it incorporates the medical power of attorney and a living will in one document.
Even though the circumstances necessitating an advance directive might occur far in the future, it is an important piece of your estate/legacy planning.