Advanced Directives 101

Avoid being adrift in a medical emergency. Have Advance Directives in place.

What is an advance directive? Documents that help people communicate their wishes if they are unable to make wishes known due to illness or injury. Three types of advance directives: medical power of attorney; out-of-hospital Do Not Resuscitate Order; Directive to physicians, family or surrogate decision-makers.

A Medical Power of Attorney:
Gives another named person the authority to make medical decisions about health care issues if the individual is no longer capable of making them, personally.
Does not apply to voluntary inpatient psychiatric care or other medical procedures such as: convulsive treatment, psychosurgery or abortion. A physician must comply with the wishes stated in the medical power of attorney or allow or arrange for the transfer of the patient to another health provider who will comply.

An Out-of-hospital Do Not Resuscitate Order does the following:
Allows for a natural death with peace and dignity in an outpatient setting
Must use the state of Texas’s mandated form
Requires 2 witnesses or 2 physicians (read and follow the form’s instructions carefully)
Applies to CPR, transcutaneous pacing, defibrillation, advanced airway management, and artificial ventilation
Applies to emergency rooms, outpatient hospital care, physicians’ offices and clinics
Does not apply to inpatient care. The DNR must be rewritten.
What? A DNR could be effective in the Emergency Room; however, the same patient could be put on full code after admission to the hospital. A DNR does not translate to hospital care.

An Advanced Directive to Physicians or “Living Will” does the following:
Tells what kind and how much life-sustaining medical treatment an individual wishes in the event of a terminal condition or irreversible condition.

An advance directive may be revoked by the individual at any time, regardless of mental status or competency. Simply put, the individual may change his or her mind.

If there are no advance directives, Texas law allows for relatives to make medical decisions. Any such decision must be in keeping with the previously communicated wishes of the patient, if the wishes are known.

Make your wishes known. Contact an elder law attorney and have your estate planning documents prepared, so that your medical care decision-making will not be left to others, not knowing what you would have wanted, leaving them at sea during an emergency.