How many times have you been in a serious accident, and while checking into the emergency room you are asked if you have an advanced healthcare directive and had no idea what they were talking about? That used to be me, but luckily law school and experience opened my eyes to the beauty and necessity of an advanced healthcare directive.
This often simple document wields an immense amount of power. Remember the Terri Schiavo case? If she had an advance healthcare directive, the battle between her spouse and her parents over her life would have had a chance to be solved peacefully. Unfortunately, she did not have one, and she made national news because of it. Before I go into why her case was such a mess, let me first explain what an Advanced Healthcare Directive (AHD) is. An AHD is a written document that lets your physician, family, and friends know your healthcare preferences, including the types of special treatment you want or don't want at the end of life, your desire for diagnostic testing, surgical procedures, cardiopulmonary resuscitation, organ donation, and more. It is normally recorded with your primary physician, your attorney, your appointed agent, and yourself. The document is able to tell everyone your wishes and requests you when you are unable to make them yourselves, and they are implemented by your appointed agent who has the power to make care and treatment decisions on your behalf, and give instructions about their healthcare wishes.
The AHD is not something that you should wait for. It is necessary whenever you are in a state of incapacitation, which can vary anywhere from a surgical procedure to an enduring coma. Therefore, in the estate planning world, an AHD is one of the first documents that you should have, as it is necessary once you reach 18. Also, let me be clear, that an AHD is not the same thing as a Power of Attorney or a Living Will. A Power of Attorney is another great document to have, but its powers do not extend to the medical decisions necessary for your life. Therefore, this document is often irrelevant in a critical medical situation. The Living Will document is another good document, but in recent years attorneys have been using the AHD in place of the Living Will because it gives more specific and practical authority to the agents under its power, where the Living Will was often too vague to apply in many situations.
Now that you have a better understanding of what an AHD is, let me tell you why not having one can cause many problems, as it did with the Shiavo case. Most Doctors are limited in their ability to provide upmost care to their patients because of fears of acting against the wishes of their patients, and therefore running the risk of malpractice. Consequently, physicians look to close family members and friends for advice of the wishes of their patients in many life-threatening and life-sustaining situations. Thus, problems arise where the parents, spouse, friends, and the dog disagree about what is best for their loved ones. If unmarried, common-law will have no legal authority to make any healthcare decisions on your behalf. Even when you're married, the parents may have more legal authority than your spouse. Thus, the disagreements can end up in never-ending legal battles. Most of these issues can be resolved though an AHD where the physician understands their patients wishes. Also, family and friends can feel better knowing that even if they personally wanted something else, in the end, their loved ones received what they wished for.
In closing, it is a good idea to have this document. However, be aware that these decisions are not easy to think about. How long would you like to be on life-sustaining machines? Would you like to receive artificial nutrition and hydration while in a vegetative state, if so, how long? Funeral requests? Each of these decisions are moralistic, realistic, and philosophical, and therefore take time to come to a conclusion. Yet, they are all real concerns, so put your thinking caps on and get to work.
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