By, Shirley Farmer, Attorney at Law
The information provided in this article is intended to give a general overview of the topic and is not intended as legal advice. For information specific to your situation, please talk with your estate planning professional.
Article #3, Advancements in Health Care Advance Directives
Deciding in advance who will manage your financial affairs when you are no longer able is important to a good estate plan. Equally important is to consider who you want to make health care decisions for you when you are not able to and making your wishes known regarding your future medical care. A medical emergency can strike at any age and can be temporary or permanent – imagine you were in a car accident or suffered a stroke or heart attack that left you unconscious or otherwise unable to communicate your wishes. Who would make decisions about your medical care? Would that person know what decisions you would want him or her to make?
Every adult should have a health care advance directive. Your directive has two main parts: 1) appointing a Health Care Representative to make the health care decisions (also called your agent or proxy), and 2) written direction regarding your wishes and preferences (often called the Living Will part) to guide your representative when making those important decisions. Having such advance directives will clarify for your loved ones what your wishes are regarding your life-sustaining care when the time comes. By completing the forms yourself while you are able, it helps reduce the stress and questions for your family and friends when you are not so able.
Choosing who you want as your health care representative is a very important decision. It is important to choose a primary health care representative as well as a backup, or alternate, health care representative who can step in if your first choice is not able or willing to make the decisions when the time comes. Your health care representatives will need to agree to accept the responsibility and honor your wishes. When choosing your health care representative, you can also indicate if there are individuals whom you do not want to make any decisions on your behalf. Choosing a health care representative does not take away any of your rights or abilities while you are still able to express your own wishes. Your representative is only allowed to make health care decisions for you when you are not able to do so for yourself.
Health care professionals are trained to preserve life. Depending on your preferences, this may or may not be what you would like to happen should your health deteriorate to an unrecoverable state. If you have not made clear what your wishes are and there is dispute among your loved ones what treatment should be given, this can cause a great deal of stress and emotional trauma for your loved ones during an already stressful time. In some cases, a guardian may have to be chosen and appointed through the courts to make the health care decisions on your behalf. This can take time and also incur expenses for your loved ones.
You are not required to make decisions regarding what care you would prefer in advance, but if you do it can provide invaluable input to your health care representative. You can choose to leave instruction regarding many health care topics, such as whether you want a feeding tube when you are no longer able to eat or drink, whether you want a breathing machine should you no longer be able to breathe on your own, and other life-sustaining medical treatment. A health care advance directive is more detailed than the more common Do Not Resuscitate (DNR) orders most people are familiar with. A DNR simply states that you do not wish to be revived if you were to stop breathing or your heart stops beating. While it is still good to have a DNR in your medical record, an advance directive enhances and expands the topics addressed to let those involved know your care preferences for a wider range of possible circumstances.
Oregon has restrictions on who may serve as your health care representative. For example, your attending physician and his or her employees cannot serve as your health care representative unless you are related. Oregon also requires your advance directive to be witnessed by two individuals, and there are additional restrictions on who may serve as your witnesses. Many agencies and establishments have forms and instructional packets available for appointing your health care representative and choosing your care preferences. Using one of the packets is recommended, or you can have an attorney write up a formal Living Will or Health Care Power of Attorney that meet the state requirements if you prefer. Though there are variations, every state has laws allowing individuals to complete health care advance directives, so a document created under Oregon law is valid and should be honored wherever you may be when the need arises.
When considering the provisions of your health care advance directives there are many important decisions to be made, and it is good to talk with a professional to discuss the options, items to include, and choices to be made. Once you have completed the forms, it is recommended to give copies to your primary physician, regular doctors, and local hospital. It is also important to give a copy to your chosen health care representative and alternate representative. It is also recommended to have a copy of your advance directive with you when you travel. You can change or cancel your advance directives at any time, and all changes should be done formally in writing just like the original document.
You’ve taken care to make provisions for the financial future, now it is time to make provisions for your future medical care, too. Complete your health care advance directive now, and let your wishes be known!