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 What are "advance directives"? What is a "Living Will"? Is a "Durable Power of Attorney for Health Care" the same as a financial "Power of Attorney"? Can someone with a Durable (Health Care) Power of Attorney overrule my Living Will preferences? Of the two, Living Will and Durable (Health Care) Power of Attorney, which is more important? How can I be sure that my health care desicion maker will follow my wishes? Are advance directives just for senior citizens? Where should I keep my forms? What happens if I don't complete advance directives documents? What legal power do my completed advance directives have? Do I have to use these forms to express my wishes? Do I need a lawyer to fill out advance directives forms? Is there an agency in Ohio that provides free legal services for seniors who have questions about advance directives?  What are "advance directives"? Advance directives are legal papers that help health care providers determine the types of medical treatment you want administered or withheld on your behalf if you become unable to make or voice those choices personally. The term "advance directive" generally refers to any pre-crisis, written medical instruction that has been properly executed so it is legally enforceable, such as:
What is a "Living Will"? A Living Will is one type of advance directive which establishes the kind of medical care you want to receive ONLY when you become permanently unconscious OR terminally ill and are unable to express your wishes regarding treatment. More details about "permanently unconscious" and "terminally ill" are in the Living Will form. Living Wills specifically allow life-sustaining treatment to be withheld, that is, nothing further will be done to prevent or postpone death. A Living Will also allows health care workers to provide care necessary to make you comfortable and relieve pain. Additionally, you have the option of filling out a part of the Living Will form that asks a physician to discontinue nutrition and hydration. However, a Living Will doesn't name a person (also known as a proxy) to make medical decisions when you are NOT terminally ill or permanently unconscious. A Durable (Health Care) Power of Attorney is needed to name a proxy for other health care decisions. back to top Is a "Durable Power of Attorney for Health Care" the same as a financial "Power of Attorney"? No. A financial power of attorney gives another person limited authority over some of your financial matters, even when you can communicate and are in good health. It can be granted - and withdrawn - at any time. A Durable Power of Attorney designates someone specifically for medical decisionmaking, usually a family member or close friend. The Durable Power of Attorney also can name two alternates for making medical decisions in case the original proxy is unwilling or unable to serve. The Durable Power of Attorney is specifically INTENDED to activate when you can no longer make your own decisions (known as legal incompetency or disability). Its statutory name is the "Durable Power of Attorney" becuase of this. back to top Can someone with a Durable (Health Care) Power of Attorney overrule my Living Will preferences? No. When a Living Will activates for a patient in a terminal condition or a permanently unconscious state, the Living Will declaration has control over a Durable (Health Care) Power of Attorney. That is, the person designated as the health care proxy in the Durable Power of Attorney must follow your wishes outlined in the Living Will. The authority of a health care proxy through a Durable Power of Attorney is limited. For example, a proxy can't withdraw "comfort care" and can only order the withdrawal of life sustaining care under certain conditions. The proxy also can't withdraw your previously given consent to medical treatment unless the physical condition has changed or the treatment is no longer effective. back to top Of the two, Living Will and Durable (Health Care) Power of Attorney, which is more important? Each document is significant for different reasons. While it's possible to have only one of these documents in place, it is better to have both prepared since each document serves a different function. A Living Will is active only when you are terminally ill or permanently unconscious, whereas a Durable (Health Care) Power of Attorney appoints someone to authorize or refuse medical treatment whenever you are unable to express your own wishes. Additionally, the purpose of a Living Will is to outline your wishes for withholding or withdrawing medical care such as life support, food or water. A Durable (Health Care) Power of Attorney gives no indication of the type of end-of-life treatment you do or do not want to receive. Both documents should be consistent, and either or both can be revoked at any time that you are able to communicate that choice. back to top How can I be sure that my health care decision maker will follow my wishes? In addition to selecting a trustworthy person, it's important to discuss your wishes with your health care proxy prior to any health crisis and preferably before designating that person as your proxy. A health care proxy should be someone who knows and respects your feelings as to:
Are advance directives just for senior citizens? No. Anyone 18 and older should have these documents in place to ensure they receive the level of medical treatment they desire in case of an automobile or sporting accident, an unforeseen complication in medical treatment or any other health crises. Extreme sports enthusiasts realize the risks they take may result in their loved ones having to make medical decisions on their behalf, and advance directives ease that burden. Parents, in particular, may find comfort in completing a variety of planning documents - such as wills designating the guardianship of their orphaned minor children or advance directives that remove an emotional burden from their adult children. back to top Where should I keep my forms ? The wishes of countless patients are disregarded because they don't let anyone know they have completed advance directives. There is no statewide registry for these documents in Ohio, although at least one national registry (www.uslivingwillregistry.com) offers this service. Once executed, advance directives should be placed in an easily accessible location, and all appropriate friends and family members should be told where they are stored. Some advise leaving advance directives copies in a refrigerator, car glove compartment or fireproof lockbox. It also would be a good idea to give a copy of your completed advance directives to close family members and individuals named as medical decision makers. Health care facilities often ask for advance directives upon admission. back to top What happens if I don't complete advance directives documents? Without a Durable (Health Care) Power of Attorney, no one has clear legal authority to make health care decisions for you if you can't make them yourself. A court process may be pursued to designate a guardian for these decisions, costing time and money. With advance directives, decisions can be made by someone you trust. When you become permanently unconscious but don't have a Living Will, the attending physician must seek an order from probate court as to whether to withdraw food or liquids. However, in the final stages of a terminal illness, your relatives may consent to food or liquid withdrawal without a court order. If no advance directives exist, health care providers will first consult with a court-appointed guardian, if any; if none, then the following will be consulted (in order): your spouse, majority of adult children, parents, majority of adult siblings, other adult blood relatives, then, adult significant others. back to top What legal power do my completed advance directives have? Advance directives protect designated decision makers and health care providers from legal liability for following your pre-crisis instructions. Although doctors and health care facilities may refuse to follow Living Will instructions, they can't stop or delay your transfer to a provider who will honor your Living Will. back to top Do I have to use these forms to express my wishes? Any written indication of your wishes is helpful to loved ones and medical decision makers who may need to act on your behalf in a health crisis. However, under Ohio law, not every document is a legally enforceable advance directive, which must contain very specific language and statements. A consortium including the Ohio Hospice & Palliative Care Organization, Ohio Hospital Association, Ohio Osteopathic Association, Ohio State Bar Association, and Ohio State Medical Association joined to produce and distribute advance directives forms. Many health care providers automatically accept this endorsed version of advance directives forms, which bears the logos of the consortium members. back to top Do I need a lawyer to fill out advance directives forms? Advance directives are available in this kit and from many providers (see FORMS page), and their step-by-step format makes it quite possible for lay people to fill out their own forms. However, an attorney can help create an overall end-of-life planning strategy, which may include wills, trusts and advance directives, and help you better understand the documents you are completing. Additionally, an attorney can act as an objective third party in helping you and your loved ones work through this difficult and emotional subject. back to top Is there an agency in Ohio that provides free legal services for seniors who have questions about advance directives? Pro Seniors' Legal Hotline provides free legal information, advice and referral for residents of Ohio age 60 and over. The Legal Hotline responds to the legal needs of callers within Ohio regardless of income or location. A legal hotline attorney can answer questions about advance directives for a senior (or someone calling on a senior's behalf). Visit http://www.proseniors.org/legal_services.html for more information. back to top |
