Body
& Soul
Advance Health Care
Directives and Living Wills: What they Are, and How to Get Them for Free
By Randi Reed
You may not want
to think about it, but the Terri Schiavo case spotlights the issues
surrounding living wills, life support, and who has the right to determine
and carry out someone's last wishes. Following is important information
everyone should know. This article is not intended as a substitute for legal
advice from a competent attorney.
What is a Living Will?
In general terms, a living will is a document that states your wishes in the
event that you require artificial life support to survive and are unable to
communicate your wishes or make your own medical decisions. A Living Will
(or Advance Directive for Healthcare and Durable Power of Attorney for
Healthcare) goes into effect only after two physicians declare you to be
incapable of making healthcare decisions for yourself. You can revoke it at
any time and can usually change your wishes simply by completing and
validating a new Advance Directive for Healthcare and Durable Power of
Attorney and destroying the old ones.
Do I Need a Living Will?
The Terri Schiavo case has highlighted the need for everyone to obtain a
Advance Healthcare Directive or Living Will. Think you don't need one? In
most states, including California, if a patient arrives at a hospital
emergency room in need of artificial life support to survive, the patient is
placed on it, then questions are asked later. So it's important that
everyone age eighteen or over (or with emancipated minor status) have an
Advance Health Care Directive to communicate your wishes in case of
emergency--especially if:
- you are not legally
married to your significant other
- you travel, drive fast
cars or ride motorcycles, or engage in dangerous hobbies
- work with pyro,
stunts, or special effects
- you have immediate
family who live far from you.
- you have a manager or
agent--who likely has some form of Power of Attorney in order to make
deals or sign contracts when you're not available. Having a Durable
Power of Attorney for Healthcare helps avoid confusion over the extent
of that person's authority.
It's extremely important for a touring musician's or crew member's
significant other to have an Advance Healthcare Directive or Living Will
as well. In the event that you're far from home and your significant
other becomes incapacitated, you don't want just anyone making important
healthcare decisions for him or her while you're trying to get a flight
out.
Never assume
that your parents, significant other, or other loved ones share your beliefs
about death, dying, or medical care, or that they know what your wishes
would be. In discussing the Terri Schiavo case with our parents, my sister
and I were surprised to discover that our parents have vastly different
opinions about this than we do...and that their wishes differ greatly from
what we would want. Far better to find out now, and get everyone's wishes in
writing. Doing so spares your loved ones from having to make difficult
decisions in the midst of an emotional crisis.
What is the Difference Between a Living Will, an Advance Directive for
Healthcare, and Durable Power of Attorney for Healthcare?
In the US, the meanings of the terms "Living Will" and "Advance Directive
for Healthcare" (sometimes called an Advance Directive for Medical
Treatment) vary from state to state. In some states they're interchangeable
names for the same document, and in others "Living Will" is considered an
outdated term. Still other states consider a Living Will a document that is
not as detailed as an Advance Directive for Healthcare, or not valid at all.
So to be safest and cover all the bases, instead of requesting a Living
Will, many experts--such as financial guru Suze Orman--advise that you
obtain two specific documents:
1. Advance Health Care Directive (which states your wishes for or against
life support, artificial nutrition and hydration, pain relief, and
resuscitation). Sometimes this is called an Advance Medical Treatment
Directive.
2. Durable Power of Attorney for Healthcare (which names the person you want
to make healthcare decisions for you if you're incapacitated).
Important: There should also be a signed and dated page in the
document which contains the names and contact information of everyone who
will have copies of the document, so that no one can question the validity
of any copies that appear. Also, in the document itself, state the purpose
of any pages you're attaching, the number of pages, and sign and date this
clause.
How Do I Get a Living Will or Where do I get the forms for an Advance
Healthcare Directive and Durable Power of Attorney for Healthcare? Do I Need
an Attorney for a Living Will? What are the Costs?
In many states, you don't need an attorney to prepare an Advance Health Care
Directive and Durable Power of Attorney for Healthcare. Forms and fees vary
state by state. In California, an Advance Health Care Directive and Durable
Power of Attorney for Healthcare are validated either by the signatures of
two witnesses who are not beneficiaries of your life insurance or estate
(which costs nothing), or by a Notary Public (which typically costs less
than $100.00). There are no other costs involved. An Advance Health Care
Directive for California, which includes a form for Power of Attorney for
Healthcare, is available at Cedars-Sinai Hospital in Los Angeles or can be
downloaded free from the Cedars website at:
http://www.csmc.edu/pdf/CAAdvanceDirective.pdf
The language of the California form at the above link is easier to
understand than most copyright forms. It's a very general document but has
space to write in additional instructions. It also designates whom you
want to make healthcare decisions for you (Power of Attorney for
Healthcare), and has a section which gives or denies permission for organ
donation. Other hospitals and nursing homes have the forms as well.
Forms for other states can be found free of charge at:
http://www.uslivingwillregistry.com/forms.shtm.
You can also check with your local hospital, nursing home, or state health
department.
Choosing an Agent for Power of Attorney for Healthcare
The person you designate to make healthcare decisions for you if you are
incapacitated is called the "agent." The Durable Power of Attorney for
Healthcare form has a space for you to name this person, as well as
alternates if that person is unable or unwilling to act on your behalf. In
many cases, as with the California form above, the Durable Power of Attorney
for Healthcare also gives your agent for healthcare responsibility for
authorizing an autopsy and directing what happens to your remains.
Choosing your agent for healthcare is a very personal decision. You should
never feel pressured to choose someone because it seems like "the right
thing to do." It's vital to choose someone who's good in a crisis and who
can be trusted to carry out your wishes regardless of the emotion...So you
may or may not feel comfortable choosing your closest loved one. It's also
important to choose someone who either has beliefs on death, dying and
healthcare that are similar to your own or is willing to set aside their
beliefs and opinions to carry out your wishes. Discuss your wishes with your
potential agent and alternates to be sure they're willing to do this for
you. (It should go without saying that anyone with a history of domestic
abuse or other violence should automatically be excluded from your list of
potential healthcare agents.)
Where Should I Keep the Documents?
Never keep your Advance Healthcare Directive and Durable Power of Attorney
for Medical Care in a safe deposit box or bank vault; many states seal them
in the event that the owner is incapacitated, rendering the documents
inaccessible.
Instead, give copies to several trusted people who are good in a crisis and
can be counted on to keep them in a safe place, such as your physician,
attorney, manager, significant other, best friend, parents, or spiritual
advisor. (If you're in a touring band, your manager should always have a
copy in case of emergency.) Include in the document a signed and dated
addendum page listing names and contact information of all the parties
you've given copies to so it's clear how many copies are out there, and who
has them. This way, there are no surprises or accusations of invalid
documents by anyone in the heat of emotion. (An addendum for California
which has space to list everyone you've given copies to is part of the
California form linked above.)
For further information:
http://www.uslivingwillregistry.com/forms.shtm
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