An Advance Medical Directive (“AMD”), sometimes called a healthcare power of attorney, is a legal document that a person, called the principal, creates indicating what level of medical treatment the principal wishes to receive if the principal is incapable of communicating for themselves. It also appoints someone, called the agent, to act as the principal’s representative to communicate that level of treatment. Generally, an AMD takes effect when you have become incapacitated.
An AMD allows you to state what level of medical care you want. Specifically, you can direct that a specific procedure or treatment be provided, such as artificially administered hydration (fluids) or nutrition (feeding); direct that a specific procedure or treatment be withheld; and/or appoint a person to act as your agent in making health care decisions for you. In short, if you cannot make medical care decision, it says what medical care you do or do not want and names someone to make those decisions for you.
Your life will be in the hands of another person of your choice. Your agent has decision-making priority over any other individuals who could, by law, make health care decisions for you. It essential the person you appoint as your agent understands what level of care you would want if you are unable to speak for yourself. As an example, Sparky Anderson death demonstrates the importance of having end of life discussions with loved ones.
Communication is at the heart of the relationship. Most people appoint their spouse as their agent and have had a discussion on medical care. However, a single older client might rely on a friend or relative to act as an agent, where an in-depth conversation has not occurred. If you do not communicate your wishes the agent might make the wrong decision on medical care.
The agent has to be a person that can be trusted but also an advocate for you. The agent must make the right decision in accordance of your wishes. See the estate of the month on Gary Coleman on how important a healthcare power can be. That must mean your agent should be mentally strong enough to say “no” to treatment when it is clear you would not want a treatment even if it merely prolongs your life but does not “cure” you.
Most states have guidelines with respect to AMDs. The guidelines give the basic types of procedures and treatments that a person would either want done to them or not done. However, they are only guidelines, and a client can draft an AMD to address almost any hypothetical treatment. Some people will even get down to specific types of cancer treatment that they want or do not want. The most popular procedure people address is whether to be intravenously fed while in a vegetative state, e.g. living like Terri Schiavo but many people have different health issues they want to address.
Even with prior talks, clear instructions to your agent in your AMD document are essential because the AMD will be the agent’s directives from you. A poorly drafted AMD, or one that gives the wrong person power, might result in being subject to an unwanted treatment or possibly your death.
Creating an AMD is a complex issue that sometimes requires asking difficult questions about end of life medical treatment and how your loved ones will react to those decisions. However, it will go a long way toward giving you piece of mind.