The New Date You Should Remember: April 16th

by Procino-Wells & Woodland, LLC

April 16th is National Healthcare Decisions Day

Advance Care Planning: Health Care Directives versus Do Not Resuscitate Orders

 By: Michele Procino-Wells, Esquire

 Advance care planning is the process of considering, discussing, and documenting your wishes for medical care at the end of your life.  It is important to determine, in advance, what type of care you want and do not want used when that time comes.

When you have written your wishes down before you become seriously ill you have created a legal document called an Advance Health Care Directive.  A thorough Advance Health Care Directive has three components: 1) the appointment of an agent to make medical decisions; 2) the direction regarding your health care choices; and 3) the ability to set forth specific organ donation wishes.

Appointing an Agent

A health care agent is someone you designate to make medical decisions for you if at some future time you are unable to make decisions for yourself.  Your agent may be a family member or any other person you trust to make serious decisions.  The person you name as your agent should clearly understand your wishes and be willing to accept the responsibility of making medical decisions for you. For this reason, it is advisable to discuss your wishes with your agent and to be sure that your agent has a photocopy of your Advance Health Care Directive.

You can appoint more than one person to be your agent.  This would require your agents to act jointly in making medical decisions for you.  You can also name a person as an alternate agent who would step in if the first person named is unable, unwilling, or unavailable to act for you.

Health Care Directions

This critical component of an Advance Health Care Directive is commonly referred to as a living will.  It gives you a say about what type of medical procedures you would or would not want used if, in the future, two doctors have determined that you are incapacitated and unconscious or terminally ill.  For instance, you choose for yourself whether you would want artificial hydration or nutrition; mechanical respiration; and/or kidney dialysis if you were determined to be in one of the qualifying conditions mentioned above.  By making these types of decisions for yourself, those who care for you (i.e. family members) will not have to guess what you want or be burdened with making those difficult decisions for you.

Organ Donations

Many people elect to be an organ donor without realizing that they can give very specific direction regarding the same.  The last critical component of an Advance Health Care Directive allows you to choose what organs and/or parts you desire to be donated upon your death.  It further allows you to direct for what purpose they are to be donated and to whom.

A thorough Advance Health Care Directive that contains all three components is a key part of a well-rounded estate plan.  However, in the event of a medical emergency, an Advance Health Care Directive will have little to no effectiveness.  That is due to the fact that ambulance and hospital emergency department personnel are required to provide CPR, that is, emergency treatment to restart your heart or lungs when your heartbeat or breathing stops, unless they are given a separate directive that states otherwise.

A Do Not Resuscitate Order is a written directive that allows you to instruct medical professionals to not perform CPR.  It is entirely separate from an Advance Health Care Directive and should not be combined with one.  Do Not Resuscitate Orders do not allow you to appoint an agent to make medical decisions nor do they permit written statements regarding your advance health care decisions or organ donation wishes like Advance Health Care Directives do.

Additionally, Do Not Resuscitate Orders are designed for people whose poor health gives them little chance of benefiting from CPR.  As such, they should be taken very seriously.  Contrast that with an Advance Health Care Directive, which should be created by all adults over eighteen years of age.

Great care should be taken when considering end-of-life planning and creating either of these legal documents.  Although it is hard to talk and think about the final phase of life, it can be a huge gift to your family and loved ones to prepare them in advance for the sometimes difficult and distressing decisions that must be made.  For those who wish to plan in advance, the assistance of an experienced elder law or estate planning attorney can ensure that you have detailed documents in place that cover nearly any situation that may arise.