Your On/Off Switch…

Generally a comprehensive estate plan will include provisions for your care even while you are still alive.  Unique documents and provisions should be carefully considered while you are working with your attorney to create or amend your plans.  Many attorneys treat health care documents as boilerplate.  However, when it comes to authorizing someone else to make all of your health decisions, whether only temporarily or long-term, it is not a common, easy decision.

There are various approaches.  The most simple of the documents is called a Medical Directive or Living Will.  One approach is that you direct that if two physicians have determined that you will require heroic efforts to survive (artificial nutrition, hydration, etc.), and you are unlikely to survive or get better, they can decide not to save you.  A few cautions about your medical directive: 1. The physicians have to be aware of this power so someone must give them the directive, and 2. The physicians have to be willing to make such a decision.  Verifying their willingness to do so (some say it is a violation of their Hippocratic Oath), is key to this document.  Otherwise, you may not even want it.

The most commonly used document is the Advance Health Care Directive.  This form allows you to designate specific people who you trust to make your medical decisions in the event you are unable to do so.  Additionally, in this document you may make your treatment preferences known and the values or beliefs you wish to guide your agent’s decision.  This document can be super complex or super simple.  The complex can involve a method by which you may make your treatment preferences known and the values or beliefs you wish to guide your agent’s decision.  Amongst other approaches, this can be accomplished by a questionnaire, which contains questions and check boxes with pre-written answers.  However, you should be aware that you are free to change any response, decline to include certain sections or provisions, and make additional specifications.

Ultimately, it is up to you how broad or how specific you want your agent’s power to be.  Although the Advance Health Care Directive is generally viewed as a one-size-fits-all form, and indeed it may be easier to interpret when it follows a particular format, it is your opportunity to speak about the way you want difficult decisions made.  If you are fundamentally opposed to, say, the amputation of certain limbs, or religiously opposed to invasive procedures or blood transfusions, you should not be reticent to say so.  Similarly, if you want all necessary pain relief regardless of what it will mean, even if it may hasten your death, this is your time to state it.

Because creating your trust will often be the most complex task your attorney performs when creating your estate plan, it is invariably what you will spend the most time discussing.  Additionally, when you come in for regular trust reviews , you will often spend the majority of your time discussing changes to the distribution provisions of your trust.  However, your healthcare preferences will undoubtedly change as you age.  When you have young children, you are much more likely to want physicians to do everything they can to save your life.  When you are older, chronically ill, and terminally uncomfortable, you may change your mind toward a preference to die peacefully and with dignity.
It is literally your life we are talking about.  Take control of it.

Estate Planning: The Price of Organization, Rewards, Gifts, and Wondrous Tax Things…
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