How to Prevent Medical Conflicts

There has been a lot of talk about living wills and health care powers of attorney lately. These legal documents (often called health care directives) are important because they make your medical wishes known if you can not speak for yourself. You must take steps to ensure that your health care wishes will be honored. This is accomplished through the completion of a Durable Power of Attorney for Health Care, also called a Designation of Patient Advocate. The lack of this important document may have the question of your desire for healthcare treatment and life sustaining measures open for debate.

Here is a brief description of the five primary health care directives typically included in a Durable Power of Attorney for Health Care and how they protect your wishes:

An Appointment of Health Care Agent, also called a Designation of Patient Advocate, is the directive you use to choose someone to speak for you if you are not capable of making your own decisions. This person, called a health care agent or patient advocate, uses your health care instructions as guidance to make informed decisions about your care. It is important that you choose a trusted individual who will uphold your wishes when the time comes.

Advanced Medical Directives, also called living will provisions, are the directives you use to explain your medical preferences regarding end-of-life care and the withholding or withdrawing medical treatment in the event that you are unable to speak for yourself. These are the instructions you use to indicate whether you would or would not want a feeding tube, a ventilator, etc. These directives may also be included in a separate document called a Living Will.

A Health Insurance Portability and Accountability Act (HIPAA) Authorization allows doctors and hospitals to give your medical information to your health care agent so they can make informed decisions about your care and treatment. This authorization also allows your health care agent to release your protected health information to insurance carriers or other health care providers.

An Anatomical Gift Authorization also called an Organ Donation Authorization is completed if you wish to donate organs or other body parts to those in need or for study.

A Mental Health Care Directive allows your health care agent the authority to make mental health care decisions on your behalf if you are not capable of making them on your own. These directives may also be included in a separate Mental Health Care Power of Attorney.

Completing these documents is crucial, but it’s still not enough. It’s also essential to do a few other things.

First, you should talk to your loved ones. Tell the persons you have chosen as your health care agents that you have selected them, and be sure they are willing to do it. You also need to talk to your family about your medical wishes, especially about end-of-life care. The more information your family has about your views, the more you will help yourself and your family, should the need arise down the road to make decisions about your care. These discussions can help ease the emotional stress your family may feel in making difficult decisions about your care, particularly if you opt for less medical intervention at the end of life.

Second, if you have already completed these documents, it is important to review them periodically to make sure they still reflect your wishes. We recommend that you look at them once a year. It is especially important to update them if your family situation has changed (i.e., do you need to appoint a different health care agent?) or if there is a change in your medical condition. Also, changes in state or federal law can make it necessary to update your directives.

Third, it is also critically important that these directives be available to hospitals and doctors right away. It is vital to have your documents completed and updated, AND it is also essential that they be accessible in an emergency. One way to accomplish this is through a membership in an emergency access service for your health care directives. It will get your health care directives to a hospital or doctor that needs them at a moment’s notice, anywhere in the world. This service also supplies the names and phone numbers of your loved ones and your doctor, so they can be contacted in an emergency. As part of this membership you will receive a wallet card that instructs the hospital to call a toll-free number and the directives will be faxed to them promptly.

A Durable Power of Attorney for Health Care protects you and your family. Make your wishes known now – and prevent the conflict later.

By: Matthew M. Wallace CPA, JD

Published edited November 9, 2008 in The Times Herald, Port Huron, Michigan as: Prevent medical decision conflicts

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