The Greater Estate Plan, Part 2

Joe Plumber's health has stablized, but he remains unconscious. He is hooked up to a breathing machine and requires a feeding tube to eat. The hospital has finally located his parents, who are divorced. His father and his mother disagree over what medical decisions Joe would make if he were conscious. One wants to take him off the ventilator and let nature take its course. The other wants to keep him on until he awakes to make his own decision.

What will happen to Joe? Who is responsible for making this decision? How can they know what Joe would want?

These questions could have been easily answered if Joe had had just one thing in place: an Advance Medical Directive.

In the last post, we were introduced to the Advance Medical Directive. Today we will take a closer look at what an Advance Medical Directive might contain.

In an Advance Medical Directive, one individual – the “principal” – gives authority to another individual – the “agent” – to refuse consent (or to withdraw consent after it has been given) to medical care for the principal.

Advance Medical Directives can take a variety of forms. Generally, they contain two things: (1) the living will, and (2) the power of attorney for health care.

The first category, the living will, addresses end-of-life measures such as artificially administered nutrition and hydration (feeding tubes), artificial respiration (ventilators), and cardiopulmonary resuscitation (CPR). The person making the Advance Medical Directive uses the document to specifically grant or deny permission to use these types of medical care if he is unable to make the decisions for himself.

The second category, the power of attorney for health care, is less specific than the living will, and thus more customizable. The principal making the Advance Medical Directive uses the document to appoint an agent to make health care decisions for him if the principal is unable to make the decisions for himself. The principal can also appoint a second agent, in case the first choice is unwilling or unable to act as the agent.

For both categories of Advance Medical Directive, the instructions only take effect after a certain number of doctors (usually two) have examined the person needing medical care and declared him or her unable to communicate.

All adults should seriously consider having an Advance Medical Directive. It is far better to have one and never need it, than to need one and not have it. Anyone can suddenly find themselves unconscious and in need of medical care: car accidents, heart problems, walking through a crosswalk . . . even just slipping when getting out of the shower.

No one should leave his or her loved ones guessing – or worse, fighting – over their treatment. (Terri Schiavo, anyone?) Please consider getting an Advance Medical Directive. They are inexpensive to set up and are invaluable if they are ever needed.