Everyone above the age of 18 should consider establishing a Medical Power of Attorney/Patient Advocate Designation (PAD) to specify your wishes in the event of an emergency. Your Medical Power of Attorney/Patient Advocate Designation should be shared with your primary care physician and also any local hospital to which you may be taken should unforeseen circumstances arise.
A Medical Power of Attorney/Patient Advocate Designation is a written document that explains how you should be cared for in an emergency or if you are otherwise incapacitated and unable to make such decisions on your own. Your Medical Power of Attorney sets forth your wishes on topics such as resuscitation, desired quality of life, and end of life treatments you wish or do not wish to receive.
This document is primarily between you and an appointed Patient Advocate, and it advises them how to communicate your treatment wishes to your care providers. You should attempt to be as specific as possible in this document, but realizing that you can’t account for every possibility. A Medical Power of Attorney/Patient Advocate Designation should be updated periodically as your wishes or medical advances dictate changes.
What’s the Difference Between a Living Will and a Medical Power of Attorney/Patient Advocate Designation?
A Living Will is your own written instructions for medical treatment in the event of an emergency. A Medical Power of Attorney or Patient Advocate Designation is a legal document that grants someone else permission to make medical decisions for you in an emergency.
In some states, the Living Will and a Medical Power of Attorney is combined into a single document called an Advance Healthcare Directive.
What Should be Included in a Medical Power of Attorney/Patient Advocate Designation?
You may choose to include instructions about anything you wish in your Medical Power of Attorney/Patient Advocate Designation, what you wish to receive and for how long, and what you do not wish to receive. Some typical items include:
Life-Prolonging Medical Care
Medical Powers of Attorney can include whether or not you wish to receive life-prolonging treatments at the end of life. Such procedures typically include:
- Administration of drugs
- Cardiopulmonary resuscitation (CPR)
- Diagnostic tests
- Transfusions of blood and blood products
- Use of a respirator
Food and Water
If death is imminent from a serious illness or you are permanently comatose, you may not be able to survive without the administration of food and water. Unless specified otherwise in your Medical Power of Attorney, doctors will use intravenous (IV) feeding lines or feeding tubes to provide you with a mix of nutrients and fluids.
Patients who are unconscious can sometimes live for years with artificial feeding and hydration. When food and water are withheld, death occurs relatively quickly due to dehydration, while the patient is kept comfortable. Many people stipulate under what conditions or for certain lengths of time for artificially administered food and water to be provided.
Palliative Care (Pain Relief)
Instead of focusing on prolonging life, palliative care emphasizes quality of life and dignity by helping a patient remain comfortable and free from pain until life ends naturally. Palliative care may be administered at home, in a hospice facility, or at a hospital.
DNR Orders and POLST Forms
There are some who do not wish to receive life-prolonging treatment when close to death, and they will include a “Do Not Resuscitate” Order, or DNR Order in their Medical Power of Attorney. If a medical emergency occurs, this form alerts emergency personnel that you do not wish to receive Cardiopulmonary Resuscitation (CPR).
In many states, DNR Orders are included in a broader set of medical orders called “Physicians Orders for Life-Sustaining Treatment” (POLST). In addition to instructions about CPR, POLST forms include directions to health care providers about other life-prolonging treatments, like feeding tubes, intubation, or antibiotic use. A POLST is something like an advance health care directive or Medical Power of Attorney/Patient Advocate Designation, but it does not substitute for these documents.
Respected Living Will Lawyers
The Estate Planning Law Firm of Mall Malisow & Cooney maintains a significant presence in reputable listings such as Super Lawyers and Best Lawyers in America. Moreover, our Estate Planning Law Firm is comprised of two Attorneys who are nationally Certified Elder Law Attorneys (CELA), certified by the National Elder Law Foundation.
Our Living Will Attorneys know that making these types of decisions can be difficult. We will always strive to provide information and answer your questions with compassion and understanding. Our goal is to always serve the best interests of our clients, helping them find security and peace of mind about the future and their loved ones.