Taking Control of End-of-Life Care

September 29, 2009

Regardless of one's stance on the healthcare debate or the use of end-of-life counseling, everyone needs to have a plan in place for his or her own end-of-life decisions.

September 29, 2009 /24-7PressRelease/ -- Taking Control of End-of-Life Care

Article provided by Hall & Hall, PLC
Visit us at http://www.hallandhallfamilylaw.com

During the recent debate over the proposed government-provided health care option, there has been great controversy over the inclusion in that plan of "end-of-life" counseling, or "death panels," as critics of the plan have called them. In the now defunct House bill, the government would have provided financing for those receiving government-funded health care to have optional consultations with physicians on end-of-life care choices, including hospice care.

Critics of end-of-life counseling feared it would open the door to the government making decisions about the type and level of care each person should receive based on a cost-benefit analysis. They argued this in turn could lead to the government deciding who would live and who would die and sanction the use of euthanasia.

Regardless of your stance on the healthcare debate or the use of end-of-life counseling, the truth of the matter is that everyone needs to have a plan in place for their own end-of-life decisions. Those who do not have a plan will leave their treatment and care decisions in the hands of their families, doctors or maybe even the government. By using the proper estate planning tools, you can take control of your health care decisions now and ensure that your wishes are followed in the future.

Living Wills

Living wills are one of the easiest ways to document your wishes for end-of-life care. In Virginia, they are referred to as "advance directives."

In the living will, you can set out the circumstances in which, in the event of a terminal condition, you would like to have certain types of treatment, including the use of life-saving and life-prolonging measures, and those circumstances in which you would not. For example, you can specify in what situations you would want to be resuscitated and/or given artificial respiration and nutrition. You also can include whether or not you would like to receive blood transfusions, be hooked up to dialysis machines or be an organ donor.

There are many ways you may become incapacitated. Many people only think of situations in which they are advanced in age and succumb to a long-term illness, like cancer. But young, healthy adults also can become incapacitated by illness and other injuries, like a car accident that leaves you in a coma. Mental illness also can leave you unable to make your own health care decisions.

Living wills do not come into effect unless you are unable to communicate your wishes directly to your physician. In Virginia, two physicians must separately determine and certify in writing that you are "incapable of making an informed decision." One of these doctors must be your attending physician and the other must be a doctor or clinical psychologist who has not been involved in your treatment.

You can change the terms of your living will at any time so long as you have the mental capacity to do so. It is important to update your living will if you move to a new state, where the legal requirements for the document may be different.

Powers of Attorney

Virginia law permits you to select an agent to make health care decisions on your behalf as part of your advance directive. Often referred to as a "health care agent," this person is responsible for acting as a surrogate decision-maker for your health care decisions should you become incapacitated. The agent is required to make care and treatment decisions based on the wishes you expressed in your living will or health care power of attorney.

In the advance directive, you can specify what the agent may and may not do while acting on your behalf. Some of the powers that may be given to a health care agent include:
-The authority to review and release medical records
-The authority to authorize or decline treatment
-The authority to request a second medical opinion
-The authority to request that the patient be transferred to another health care facility
-The authority to sign consent forms and waivers of liability on behalf of the patient

Like the living will, the agent's authority to act as a surrogate decision-maker in health care matters does not come into effect until you have been determined to be incapable of making informed decisions. Should you later be determined capable of making these decisions, the agent's power comes to an end.

A financial power of attorney or durable power of attorney is another type of power of attorney that should be considered in a comprehensive estate plan. As its name implies, this authorizes the selected agent to make financial decisions on your behalf. Unlike a health care power of attorney, a financial power of attorney can come into effect as soon as it is delivered to your agent. You can specify what actions the agent is authorized to make, like paying bills, selling property or buying stock. The agent may be given access to only select financial accounts or all of them.

Conclusion

While there are many templates of sample advance directives available, it is best to receive personalized service from an experienced estate planning attorney rather than fill in the blanks on a pre-created form. Given the importance of these documents and the authority they invest in others to make decisions on your behalf, it is critically important that these documents are drafted with care -- not only to ensure that your wishes are followed, but also to protect from any potential abuses of power.

For more information on living wills, powers of attorney and other estate planning tools, contact a knowledgeable estate planning lawyer.

Article provided by Hall & Hall, PLC
Visit us at http://www.hallandhallfamilylaw.com

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