Advance directives and power of attorney

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Before you get sick, it’s important that you put in writing the instructions for what kind of treatment you would want and who could make decisions for you if you could no longer communicate your wishes.

Many people assume that their family members would automatically be able to make decisions about medical treatments and life-sustaining measures if they were to become incapacitated. This is not always true.

Rules vary greatly from state to state, but in some cases, decisions are left up to doctors and institutions unless you have appointed someone as your legal representative. If the decision falls to family, your family members may not always agree on medical treatment issues. This could lead to disagreements or even court battles over appropriate treatment, especially when it comes to end-of-life issues.

These are some of the legal documents you can use to describe how you want medical and financial decisions made if you can’t make them yourself:

1. Advance Directives: The term advance directives is often used to refer to a health care proxy and living will. These are two separate documents, but they work best together. In many states, they are combined into one advance directive document.

Generally, the most important document to have is the health care proxy. In some states, you may hear it called a durable power of attorney for health care, medical power of attorney or appointment of a healthcare agent. This document allows you to name someone you trust as your proxy, or agent, to express your wishes and make health care decisions for you if you can’t do so because of a temporary or permanent illness or injury. This is called being incapacitated. You health care agent is usually allowed to make almost any medical decision that you would be able to make yourself if you could communicate your wishes. It’s important to know that the word proxy can be used to refer to the person or the legal document.

A living will usually has a more narrow scope. It describes the type of care you want to receive as you near the end of your life in specific circumstances. It typically goes into effect only when you are incapacitated and your doctor certifies that you are nearing end of life. You may also hear a living will called a directive to physicians, health care declaration or medical directive. It works best as a guide for your health care agent and doctors to make sure your health care preferences and wishes are followed.

2. Power of attorney: A power of attorney is a legal document that lets another person (your agent or attorney in fact) to make property, financial and other legal decisions on your behalf. Your agent may play an important role in your health care, as he or she can pay for health care, choose health insurance policies for you and appeal coverage denials. You may appoint the same person to be in charge of medical and financial decisions by giving them power of attorney and naming them as your health care agent. However, to do so requires two separate documents.

Your doctors should make note of your advance directives in your medical record. Give these documents to the hospital upon each new admission. If you go to the hospital by ambulance, take these documents with you if you can.

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Health care proxies

Living Wills

Power of attorney

American Bar Association's (ABA) Consumer Tool Kit for Health Care Advance Planning

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