Some Definitions

Principal: The person (you) who creates the Health Care Directive and who appoints the agent.

Agent: Someone appointed by you (the principal) to make decisions about your medical care if you cannot make those decisions yourself. Most often, agents are family members or close friends.

Capacity: The mental ability to understand the nature and effects of one’s acts.

Guardian: A person who has the legal responsibility and duty to take care of the person and manage the property of another person who, due to age, understanding or self-control, is considered to lack the capacity to do so themselves.

Why Have a Health Care Directive?

A health care directive is important as it sets out your wishes for your health care in the event you lack the capacity (either due to physical or mental incapacity) to make or express your wishes to your attending physician.

It is also important to have a health care directive if wish to have someone else make your health care decisions for you.

Your attending physician will determine when you lack capacity to make decisions. However, you may wish to have someone other than your attending physician to determine when and if you lack capacity to make your own health care decisions. In that case, you may state in your health care directive who you want to make that decision.

Do You Have to Have a Health Care Directive?

You do not have to have a health care directive. However, having one assures that your wishes for your health care are followed in the event you are unable to make or to communicate your decisions for your health care.

A health care directive is one of the most important gifts you can give to your family. By making your wishes known in advance, you will make it easier on those who will have to make health care decisions for you as well as your loved ones by knowing that the decisions being made are consistent with your wishes.

What Happens If You Don’t Have One?

You will still receive medical treatment if you do not have a written directive. Health care providers will speak to people close to you and listen to what they have to say about your treatment. However, the best way to assure your preferences are followed is to put them in writing.

How Do I Choose My Agent?

Most people will appoint a spouse, family member or close friend to be their health care agent. Here are some things to consider when choosing an agent:

1. Not everyone makes a good agent. An agent should be assertive and not afraid to ask question of doctors and other health care providers so they can be assured of knowing what they need to make a decision. 2. Make sure the person you designate as your agent is willing and able to take on the responsibility. Let’s assume for a moment that you have indicated in your health care directive that you wish to be made comfortable and not continue medical treatment if in the estimation of your physicians you will not regain a full and meaningful life. Physicians will not always be able to make that determination with 100% accuracy and may end up leaving that decision in the hands of your agent. As someone who has made the decision to cease medical care for a loved one and let them pass, I can tell you with first hand experience how difficult a decision that is. 3. If possible, designate an alternate agent in case your first choice is unable to serve when the time comes. 4. Clarify with your health care providers what role you want your agent to play. 5. Ask your physician how he or she has worked with agents in the past. What problems have they had and what you can do to ensure that such problems will not occur with your agent. 6. Talk to your agent to determine that they are willing to act as your agent first and foremost. Then be sure to discuss your wishes regarding your end-of-life medical treatment. These discussions can help your agent with potential guilt and anguish whether or not they are doing the right thing.

How Do I Act as a Good Agent If I am Asked?

1. Have discussions with the person asking you to be their agent so you fully understand their wishes. What are their views on medical technology? How much medical care would they want if they were diagnosed with a terminal or irreversible illness and were unable to communicate? 2. Educate yourself about the patient’s illness so that you can anticipate decisions you may have to make. 3. Be assertive. Don’t be afraid to ask questions. If you do not understand the medical terminology being used, ask for clarifications. 4. Speak up if you do not feel that health care providers are respecting your role as agent. 5. Find out what support you will get from the hospital and/or who to speak to if you run into problems acting as the agent. 6. Make sure your role as the agent is clear to not only the medical community but to the person’s family as well to avoid conflicts when difficult decisions need to be made.

How Do I Make A Health Care Directive?

A health care directive has a number of legal requirements that must be met:

1. It must be in writing. 2. It must state your name. 3. It must be signed by you or someone you authorize to sign for you when you can understand and communicate your wishes. 4. Your signature must be verified by a notary public or two witnesses. 5. It must include the appointment of an agent to make health care decisions for you and/or instructions about the health care decisions you wish to make.

If you have additional questions about health care directives or need to create one to give your family peace of mind, call us today at (763) 420-5087.

Chuck Roulet
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Nationally Recognized Estate Planning Attorney, Author, and Speaker