Being diagnosed with a life-changing or life-threatening illness is frightening. In addition to receiving a scary diagnosis, all the meetings with physicians, researching treatment options, having family discussions, and decision making can quickly become overwhelming and exhausting.

The seemingly endless medical and insurance paperwork turns into a full-time job – at a time when you need all your strength and energy to focus on battling your illness.

With the hope of taking some of the confusion out of the process, we’ve developed the following synopsis of legal and medical documents that can assist you, your family, and your medical providers. These documents, sometimes referred to as Medical Advance Directives, can help ensure your wishes regarding your medical treatment and end-of-life care are understood and carried out by all involved.

Designation of Health Care Surrogate

This is a legal document that:

• Is also known as a medical power of attorney for health care;
• Sets forth your wishes for general medical treatment regardless of whether or not you have a terminal illness;
• Names a “health care agent/surrogate” or “power of attorney for health care” to discuss treatment options with your health care provider and who can make health care decisions in your stead should you become unable;
• Can be created at any time during legal capacity; and
• Includes a “HIPAA waiver,” which is a waiver of the medical privacy requirements to eliminate potential legal barriers to communications between your agent and your health care providers.

Living Will

This is a legal document that:

• Outlines treatment (or withholding thereof) desired by patient in a terminally ill or vegetative state who are without the capacity to make medical decisions themselves;
• Can be created at any time during legal capacity; and
• Can include specific comfort care and religious preferences.

How to Create a Designation of Health Care Surrogate or Living Will

While there are “do-it-yourself” forms online for both the Designation of Health Care Surrogate and Living Will, we recommend they be prepared by an attorney to ensure validity. Please contact our office to learn how affordable these very important documents can be.

DNR – Do Not Resuscitate Order

This is a medical document that:

• Can only be issued by a physician;
• Is only issued upon diagnosis of an illness or condition likely to cause death within the next year;
• Tells emergency personnel that you do not want CPR (cardiopulmonary resuscitation), which includes NO chest compression, electric shock treatments, tubes placed in airways, artificial ventilation, or cardiac drugs;
• Does not address any other type of medical treatment; and
• Applies only when a person doesn’t have a pulse, is not breathing, and is unresponsive.

POLST – Physician Orders for Life-Sustaining Treatment

This is a medical document that:

• Is relatively new in the medical/legal arena;
• Is a “portable, actionable” medical order executed by a physician (form stays with patient regardless of where patient is);
• Should be created by a physician and patient together (or health care surrogate if patient is unable to communicate);
• Is only issued upon diagnosis of an illness or condition likely to cause death within the next year;
• Has three to four sections regarding wishes on:
  • CPR;
  • Medical Interventions;
  • Antibiotics; and
  • Artificially administered hydration/nutrition
• Communicates medical orders and patient’s treatment wishes regardless of whether situation is life threatening (i.e. dialysis, etc.);
• Provides more info to emergency personnel than a DNR;
• Provides instructions to EMTs when patient has a pulse, is breathing;
• Provides instructions to EMTs when patient is responsive; and
• Must be signed by health care professional to be valid;

You can learn more at www.polst.org.

If you have any questions, please don’t hesitate to reach out to the Marks Gray Estate Planning Team. We’re here to help guide you during this difficult time.