Health care directives, also known as advance directives, health care proxy, or living will documents, are legal instruments that allow individuals to outline their medical treatment preferences and appoint a trusted person to make health care decisions on their behalf if they become unable to do so.
Health Care Directives:
1. Purpose: Health care directives are essential components of comprehensive estate planning. They enable individuals to maintain control over their medical care by specifying their preferences and instructions for medical treatment, particularly in situations where they are incapacitated or unable to communicate their wishes.
2. Types of Health Care Directives:
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- Health Care Power of Attorney/ Directive (Health Care Proxy): This document appoints a trusted individual, known as a health care agent or proxy, to make medical decisions on your behalf if you are unable to do so. The agent should be someone who understands your values and preferences regarding medical treatment.
- Living Will: A living will (either stand-alone or within the Health Directive) allows you to specify the type of medical treatment you wish to receive or refuse if you are terminally ill, in a persistent vegetative state, or otherwise unable to communicate your preferences. It outlines your wishes regarding life-sustaining treatments such as artificial nutrition and hydration, mechanical ventilation, and resuscitation efforts.
- Do-Not-Resuscitate (DNR) Order: A DNR order ((either stand-alone or within the Health Directive) instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) if your heart stops beating or if you stop breathing. It is typically used when individuals have a terminal illness or are in poor health and do not wish to undergo aggressive life-saving measures.
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3. Legal Requirements: Health care directives must comply with state laws, which vary in terms of document requirements and validity. It's crucial to ensure that your directives are properly executed, signed, and witnessed according to state regulations to be legally binding.
4. Benefits of Health Care Directives:
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- Empowerment: Health care directives empower you to make decisions about your medical care and ensure that your wishes are known and respected.
- Relief for Loved Ones: By clearly outlining your preferences in advance, you relieve your loved ones of the burden of making difficult medical decisions on your behalf during times of crisis.
- Consistency: Health care directives help ensure consistency in medical care by providing guidance to health care providers regarding your treatment preferences.
- Peace of Mind: Having health care directives in place provides peace of mind, knowing that your medical wishes will be honored even if you cannot communicate them yourself.
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Integration with Estate Planning: Health care directives complement other estate planning documents such as wills, trusts, and powers of attorney. They ensure a comprehensive approach to managing your affairs and provide continuity in decision-making across different aspects of your life.
The importance of creating and executing legally binding health care directives is illustrated in the 1990 Terri Schiavo case:
In 1990, Terri Schiavo, a 26-year-old woman from Florida, suffered a cardiac arrest, which resulted in severe brain damage, and was declared brain dead by her doctors. Terri's husband sought to remove her feeding tube, claiming she told him she did not want to be artificially kept alive. Terri's parents disagreed, believing Terri could improve with rehabilitation. For 15 years, her husband and parents battled over who had the authority to make medical decisions for her. The U.S. Congress and Florida Governor Jeb Bush passed legislation to keep Terri alive. The lower courts found that her husband had the right to make Terri's medical decisions. Appeals by Terri's parents and legislative interventions prolonged the legal battle for years. In March 2005, Terri's feeding tube was removed after a final appeal. She died 13 days later. The entire battle would have been avoided had Terri executed a comprehensive Healthcare Directive.
Creating health care directives is an important step in estate planning, ensuring that your medical wishes are respected and that you have a trusted advocate to make decisions on your behalf if necessary.
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