Living Wills and Health Care Power of Attorneys

Medical science has made it possible for people to survive illnesses or injuries that used to be fatal. Medicine is able to keep people alive who would be dead except for life sustaining machines or the artificial provision of nutrition and water through tubes or other techniques. Often there is quantity of life, but no quality of life. Once such heroic care is begun, who is able to make the decision to stop it and allow the patient to die? 

Until recently, the decision often rested with the patient's family members acting in consultation with the patient's physicians. Because of questions of possible legal liability and because of changing relationships between doctor and patient, such informal arrangements are not usually possible anymore. The courts are often asked to appoint a guardian to make health care decisions for a person unable to do so for himself. This can be expensive, time-consuming and can lead to decisions that might not reflect the personal wishes of the patient. 

These questions arise not only with regard to life and death matters, but are involved any time there is a patient unable to make or express decisions about medical care, personal matters or possible institutional placement. 

There are legal tools available to give someone authority to make and enforce such decisions for you if you become disabled. 

What You Need To Know 

If you are concerned about how your personal affairs are conducted, how your personal care is arranged for and how your medical decisions are made if you become disabled, there are several choices you can make now to assure that your own preferences are honored. 

First, you should consider naming someone as your agent in a Durable Health Care Power of Attorney or Health Care Proxy. This document, now recognized everywhere in the United States, allows you to designate someone (as well as at least one alternate) to have legal authority to grant or refuse any consents needed to obtain or refuse any kind of medical or other health care treatment. The Power of Attorney can be very specific as to what the agent may approve or refuse or it can be very general, relying on the agent's discretion. Such a power of attorney is always revocable and amendable at any time. The agent will be able to review your medical records, consult with your caregivers and sign any forms that may be needed to assure care according to your preferences. 

Second, you should sign a Living Will or Health Care Declaration. A Living Will is a statement of your preferences about medical care in the event of a terminal illness. It describes how far you want your physicians to go in providing care when death would otherwise be imminent. It further provides for carrying out your wishes about relief from pain. Unlike the Health Care Power of Attorney, the living will applies only in a terminal illness; the power of attorney is effective anytime you cannot express your own wishes.