If you're living with a chronic illness, you're in the right place.

Friday, August 29, 2014

Why You Should Have Medical Power of Attorney

1:44 PM Posted by Tiffany Taft ,
This week one of my clients who is undergoing a rather major surgery today asked me if she should write down some of her wishes in the event something went wrong.  She was thinking more along the lines of a last will and testament, but the conversation steered to documenting her wishes for lifesaving medical treatment.  This client is in her 20s, so not exactly the age where you typically think about end-of-life issues.  That's for our parents or grandparents, right?  Nope.  No matter your age, and really your health status, you should consider having a medical power of attorney.


For those of us who live with a chronic medical illness, this becomes a bit more salient.  We often undergo procedures, take regular medications that may have risky side effects, or will need surgery.  Obviously the odds of something going wrong are typically quite small, but as they say - shit happens.  Having a medical power of attorney can better guarantee that your wishes will be adhered to should something go catastrophically wrong.  Without a medical power of attorney, things can get messy.  Remember the case of Terri Schiavo?  That went all the way to Congress, the White House, and the U.S. Supreme Court in a highly publicized, and rather bitter battle, between her family and her husband about Terri's right to die.

So what is medical power of attorney, exactly?  A person whom you grant this role is in charge of informing the hospital, your doctors, and any other interested parties in your preferences for what medical treatments you want, and do not want, should you not be able to speak for yourself - often called your "agent."  The legal term for you not being able to speak for yourself is "lacking capacity" which means you can't understand the nature and consequences of healthcare choices available and/or you're unable to communicate your wishes through speech, writing, or gestures.

So this is a pretty big deal.  You want to choose a person who you trust to put your best interest above anyone else, who has the strength to advocate for you when you cannot, and will ensure what you document is actually followed.

Every state has their own medical power of attorney forms that can be downloaded off the internet for free (Here's the Illinois form as an example). Simply google "medical power of attorney + [your state]" to find one.  There is no need to use a lawyer unless you would like legal counsel.  The forms are self-explanatory and easy to fill out.

After you decide who your primary power of attorney agent will be, you'll need to select at least 2 backups. These are in case your primary person cannot (or will not) perform their role.  These alternates should have the same qualities of the first person you select.

On a typical form, there are 3 options to choose from regarding medical treatment.  You should also be able to write any additional comments on the free form about treatments you would like or would want withheld.  Typical options include:
  1. I do not want my life to be prolonged nor do I want life-sustaining treatment to be provided or continued if my agent believes the burdens of the treatment outweigh the expected benefits. I want my agent to consider the relief of suffering, the expense involved and the quality as well as the possible extension of my life in making decisions concerning life-sustaining treatment.
  2. I want my life to be prolonged and I want life-sustaining treatment to be provided or continued, unless I am, in the opinion of my attending physician, in accordance with reasonable medical standards at the time of reference, in a state of “permanent unconsciousness” or suffer from an “incurable or irreversible condition” or “terminal condition”, as those terms are defined in Section 4-4 of the Illinois Power of Attorney Act. If and when I am in any one of these states or conditions, I want life-sustaining treatment to be withheld or discontinued.
  3. I want my life to be prolonged to the greatest extent possible in accordance with reasonable medical standards without regard to my condition, the chances I have for recovery or the cost of the procedures.
The good news is you can amend your medical power of attorney documents at any time, should your opinions change about what you would like.  It is a legally binding document that hospitals and physicians must abide by, so it should be kept in a secure place that those designated on the form are aware of and can access.

Please remember that this form can be challenged or nullified, but it's difficult to do unless you're the one making the change.  Here are a few times this may happen:

  • You revoke the document.
  • If you're married and put your spouse down as your medical power of attorney then get divorced, then the agreement is nullified.
  • Someone argues in front of a court that you were not of sound mind and judgment when you filled out the forms, and the court agrees.  
  • Someone argues in front of a court that your primary agent is not acting in your best interest, and the court agrees.  Your first alternate will assume the role.
This is a personal, yet important, decision to discuss with your family and the people you want to act on your behalf for healthcare decisions.  Hopefully you'll never need it, but it's nice to know it's there if you do.

Best,
Dr. T