What is a Medical Power of Attorney?

A medical durable power of attorney (or healthcare proxy) allows you to appoint a person you trust to act on your behalf as your healthcare agent (or surrogate decision maker). This is a person who is authorized to make medical decisions should you become unable to do so.. As with a living will, before it is possible for a a medical power of attorney to legally go into effect, a person's physician must conclude that the patient is unable to make his/her own medical decisions. In addition, if it is determined that a person has ever regained the ability to make these types of decisions, the agent cannot legally continue to act on that person's behalf. These documents are usually legally binding even when they come in conflict with the wishes of the individual's immediate family.

Many states have additional legal requirements that apply only to decisions concerning life-sustaining medical treatments. For example, before your agent can refuse a life-sustaining treatment on your behalf as directed in your living well, a second physician may have to confirm your primary doctor's assessment that you are incapable of making treatment decisions.

Although it has been reported statistically that not all states have a good track record in following them, advance directives are legally valid throughout the United States. While you do not need a lawyer to fill out an advanced directive or living well, your advanced directive becomes legally valid as soon as you sign them in front of the required type or number of witnesses. Since there is such variance from state to state concerning the laws which govern a living will it is important to complete and sign advanced directives that specifically comply with your state's law.

Be aware that emergency medical technicians cannot honor living wills or medical powers of attorney. Once emergency personnel have been called, they must do whatever is medically necessary to stabilize a person for transfer to a hospital, both from accident sites and from a home or other facility. Only after a physician fully evaluates the person's condition and determines the underlying conditions, can advanced directives be implemented.

The advanced directive or living will form from one state does not always work in another state. Some states will unconditionally honor advanced directives written in another state; others will honor out-of-state advanced directives as long as they are similar to the state's own living will law; and some states do not have an answer to this question. The best solution to this problem is to research and complete the advanced directives for all the states you spend a significant amount of time in (for example, if you live in one state for at least six months of the year, yet have a summer or winter home in another state such as Florida, you should complete an advanced directive for your home state and also one for the state which contains your second residence).

Advanced directives do not expire, and will remain in effect up and until such time as you change them. If you complete a new advanced directive, it invalidates the previous one, so you should review your advanced directives periodically to ensure that they still reflect your wishes. If you want to change anything in an advanced directive once you have completed it, complete a whole new document.

In many states you can obtain copies of free living wills from your physician's office, hospital or medical facility, or by contacting your local Legal Aid group or Office for the Aging. You might also find forms by searching online where free state-specific blank documents may be downloaded either in Word or PDF format. Once you have downloaded and printed the advanced directive, keep a blank copy of it so that you can make new copies in order to effect changes to it in the future, if necessary.

Once you've completed your living will, experts agree that you should take the following steps. Although it may be uncomfortable, clearly discuss with your family and friends your wishes for what you do and do not want in the form of medical treatment (such as withholding medical treatment in the event a certifiable brain death), organ/tissue donation, etc. If it becomes apparent that you aren't able to discuss details, make sure that it is clearly understood that there is a living will/healthcare proxy in effect that contains a written record of your final wishes.

Make sure there is a copy on file with each of your physicians (or nursing home/senior residence administration, if applicable), in your important papers in each and all of your residences, and with the person whom you have appointed as your health care surrogate. Keep extra copies in a convenient location so they may be quickly located and presented to any physicians who might have to treat you in an emergency situation. If you must travel frequently for business or pleasure, be sure to carry a copy with you along with any important papers you might need, such as your car insurance coverage proof cards or passport. Be sure carry a new copy of the document any time that the advanced directive is modified or changed, and destroy any old or outdated versions.

While no one likes to think of finding oneself inthis type of situation, it really is important to see that a living will/healthcare proxy is put into effect as soon as is possible. This way you can rest assured that your wishes are carried out and the decision to carry on medical treatments you may not believe in cannot be perpetrated by those who might not be involved in your decision-making.