What Does “Do Not Resuscitate” Mean to You?
January 29, 2010
Everybody seems to know (from popular TV shows, if nothing else) that DNR means “Do Not Resuscitate”, but do you know what “Do Not Resuscitate” means in your own personal healthcare directive or living will? Too often, when talking with clients about the healthcare documents in their estate plans, they don’t know the extent of their own (or their parent’s or grandparent’s) instructions.
“Do Not Resuscitate” can cover a wide array of options, which is why it is so important to define what “life-saving procedures” means to you, and exactly when you would like your DNR to go into effect. Here are some examples of “life-saving procedures” that you (or your elderly relatives) should talk about with family, medical staff, and your estate planning attorney:
Artificial Nutrition and Hydration When grandma decides to stop drinking fluids orally and begins to dehydrate, does the nursing staff have permission to keep her hydrated via IV fluids? What about if you are in a non-reversible coma and unable to drink liquids on your own?
Antibiotics or Other Medicines Do you include antibiotics in your definition of “life-saving procedures?” Do you still if you have been declared irreversibly brain-dead by two independent physicians? When you are 102 and confined to a bed in a nursing home, do you want to be given medicines to combat pneumonia or other illnesses?
Chemotherapy A point similar to the paragraph above; if you are 102, afflicted with dementia and confined to a bed, do you want to receive expensive and painful chemotherapy treatments if the doctors discover cancer?
Blood Transfusions Blood Transfusions are fairly universally considered “life-saving procedures”, and they should be addressed in your healthcare documents. Do you have religious reasons for refusing a blood transfusion? Do you still want one if you are severely and irreversibly disabled?
Organ Donation Though obviously not considered a “life-saving procedure”, organ donation is a topic you should discuss with your family, medical providers, and estate planning attorney to prevent any misunderstandings or delays in treatment if and when the situation arises.
A healthcare directive is one of the most important documents in your estate plan. State-specific healthcare directives or living wills can often be found for free online or at your doctor’s office, and in a pinch these will work; but they cannot take the place of a conversation with a knowledgeable estate planning or Elder Law attorney who will ensure that all aspects of your decision-making process are addressed and put down in writing. After being discussed and incorporated into your Advance HealthCare Directive, you should then discuss them with your agent, which is usually a member of your own family. Be proactive in this effort, and it will save grief for the family and help ensure that your wishes are followed.
How to Pick the Perfect Health Care Agent
December 21, 2009
Cicero said “In nothing do men more nearly approach the gods than in giving health to men,” a quote which underlines the important role of anyone involved in your health care, whether it be a doctor or an agent. A health care agent is the person who makes medical decisions for you if you are unable to make them for yourself, decisions which often pertain to life and death, and can include the very difficult decision of whether or not to continue your life with artificial means. You certainly want to have someone in this role who is close to you, someone you can trust, but that is not the only criteria you may want to think about. You’ll want to make sure your agent is also someone who will ask smart questions, work thoughtfully with your doctor, and take an active role in making sure that your wishes are followed. The role of health care agent can be very “close to the gods” indeed, and should be taken seriously as such.
If you have a vague idea of what a health care agent is and does, but aren’t quite confident in the fact, the California Office of the Attorney General has provided this very informative article on the subject, which addresses not only the definition of health care agent, but also includes helpful tips on how to choose the best person for the job, as well as important things to keep in mind if you are the person who is acting as agent for someone else.
A Living Will Is Good For You, Good For The Country
August 7, 2009
President Obama’s pet project of health care reform seems to have a lot of people worried. His talk of living wills encouraging people to specify their end-of-life wishes in particular are the topics bandied about most often in tense (or downright frightened) conversations. Some people seem to think that the very act of specifying your wishes in a living will is going to put you on the Do Not Resuscitate list. We’re here to tell you that nothing could be further from the truth.
In fact, creating a living will is a smart idea, one that can save no small amount of expense, suffering and confusion on the part of your family and your medical care providers, and we aren’t the only ones who think so. Robert Powell of The Wall Street Journal’s MarketWatch agrees with us, and has written an excellent article answering the frequently asked questions about living wills, explaining the differences between a living will and a health care directive, and outlining why each and every adult should have one of these documents.
If you still aren’t convinced you should have a document specifying your wishes for end-of-life treatment, talk to any friend or acquaintance who has been through this final act of love in supporting a family member at end of life. When you are ready, we can help you execute the documents you need to get the care you want when you aren’t able to care for yourself. A living will or health care directive is a standard document in any estate plan, so if you’ve been considering creating an estate plan this may be a good time to take the plunge. Apparently executing a living will or health care directive is no longer beneficial only to you and your family; it’s also good for your country.
A Matter of Faith: Advanced Health Care Directives and Religion
June 26, 2009
The subjects of life and death are not generally considered legal topics, but rather spiritual ones; they push us to examine the very nature of humanity and the existence (or not) of a soul, touching on our most deeply held beliefs. As a document that deals directly with these issues in the most personal manner, the Advanced Health Care Directive (also known as a Medical Power of Attorney) is not one to be taken lightly by attorney or client. Some clients come into the process strong in their beliefs and choices and knowing exactly which language to include; for others this may be the first time they have considered the subject in such a personal way, and may require more time and discussion.
The links provided below provide philosophical discussion and official views and language for most of the major religions practiced in our society. Although much information is available, the official views of some faiths were more difficult to find than others. If your religious views are not included here please contact the head of your church or your own spiritual leader for guidance.
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Mnhospice.org includes general statements about a number of issues relevant to health care directives
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Beliefnet.org provides forms and resources for numerous states and faiths in one convenient place.
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Jehovah’s Witness report on rules pertaining to blood transfusions and medical treatment
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Islamic position on medical care and ethics
Jinies.com