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De-Mystifying Advance Directives

National Healthcare Decisions Day on April 16 promotes awareness of advance care planning by encouraging conversations about your healthcare choices and preferences. The pandemic has emphasized the critical importance, regardless of age, of expressing your wishes regarding medical treatment in emergency situations or at the end of life. Now is the time to create or update your Advance Directives.

First it is important to note that your healthcare options depend on your state – and it is important to understand what Ohio’s laws allow or do not allow when expressing your wishes. Each state also has specific requirements as to how documents must be executed and witnessed to be effective and legally binding. Beware of online services that promise to give you legally compliant documents, regardless of the state.  

Two documents that comprise a person’s Advance Directives are the Health Care Power of Attorney and the Living Will Declaration. These documents help plan for incapacity, and thus are only effective in specific circumstances. They are two separate documents that address different aspects of medical care, and you may choose to execute only one or both depending on your wishes. It is important to consider and understand each document before executing it and each can be updated throughout your lifetime.

A Health Care Power of Attorney designates an individual, your “Agent,” who is authorized to make healthcare decisions on your behalf if you are unable to do so. It only applies to medical situations in which you are unable to express your own wishes. Typically, an Agent and alternate Agents are named in order of priority, and you should discuss your wishes with your Agent and alternate Agents ahead of time. According to law, there are specific actions your Agent is allowed and not allowed to take; for example, your Agent is not able to refuse treatments that alleviate pain or keep you comfortable.

A Living Will Declaration, despite having a similar name to the Last Will and Testament, does not dispose of any assets. A Living Will allows you to decide the type of care you would like to receive if you are unable to express your own wishes regarding healthcare and are in either a terminal condition or in a permanently unconscious state. It is only effective in these limited circumstances and affects healthcare that artificially or technologically postpones death. A Living Will gives your physician authority to withhold or withdraw life-sustaining treatment, providing you with only care necessary to make you comfortable and relieve your pain. Such action can only be taken if two physicians have verified your medical status. A Living Will is different from a Do-Not-Resuscitate (DNR) Order, although a Living Will may authorize your healthcare provider to issue one. You must deliver your Living Will Declaration to your healthcare provider to be effective.

Without effective Advance Directives, your family and health care providers may be left to make these decisions for you, creating potential for disagreement. These disagreements can quickly get contentious and complicated by legal proceedings that can delay medical decision-making and prolong your incapacitated health status. With Advance Directives, you make clear not only what your decisions are ahead of time, but also who you trust to make decisions in unprecedented situations.

National Healthcare Decisions Day is intended to inspire conversations about your healthcare wishes and Advance Directives are an important part of making legally binding expressions of your decisions.

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