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Can You Really Afford to Wait?
January/February 2007
If you have been considering a
medical/healthcare proxy, also known as a medical power of
attorney, you may have already begun to think about whom you
wish to name as your Agent and his/her alternative together
with instructions you want give for your care if you are
unable to express your wishes. If you are one of almost 25
million Americans who already have a proxy, you may want to
revisit certain issues, especially in light of the public
and private tragedy experienced by Terry Schiavo’s family. A
medical/healthcare proxy ensures that everyone, regardless
of family circumstances, retains control over his/her health
care. Without a written proxy, partners or other loved ones
may not be able to participate in decisions regarding
medical treatment, your care decisions may be made by
someone lacking knowledge of your wishes, making it more
likely that you could be given treatment that you would not
have chosen for yourself.
This article is an overview of the issues and is intended to
assist you in making an informed decision. Not everything
may be applicable to your situation. It is important to make
informed and considered decisions, especially relating to
selection of your Agent and his/her alternative in the event
that he/she is unable to serve, and establish clear and
concise instructions for your care. Remember that the need
for a proxy is not limited to end-of-life situations, but
any situation in which you are unable to make your own
decisions, even if it is only for a short period of time.
Getting Started…….
There are three basic areas to consider before preparing a
medical/healthcare proxy (power of attorney) or when you are
reviewing your existing one.
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Explore your own circumstances
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Identify individual(s) you want to make
treatment decisions for you in the event you are unable
to make them for yourself
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List specific instructions (if any) you
want to tell your Agent(s)
Exploring your own circumstances
There are a number of questions you may want to consider
before preparing a medical/healthcare proxy or when
periodically reviewing an existing one:
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What is the present condition of my
health?
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Do I have special medical needs?
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Do I hold any religious or moral views
about medicine or particular treatments?
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What do I value most about life?
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How do I feel about death & dying?
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Do I believe life should be preserved as
long as possible?
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What circumstances would make me think
that treatment to prolong life should or should not be
used?
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Is the amount of pain I am experiencing
or will experience a consideration?
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Does it make a difference if the pain is
temporary or permanent?
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Is the likelihood and degree of recovery
a consideration?
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Is my age a consideration?
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Is the age of my spouse/partner (if any)
or the ages of my children (if any) a consideration?
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Should financial considerations
influence decisions about my medical care?
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Are there other beliefs or values that I
hold that should be taken into consideration by those
making medical decisions for me?
Selecting an Agent(s)
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Is there someone who is already familiar
with your overall medical situation?
-
Is there someone who is already familiar
with your wishes regarding medical treatment?
-
Is there someone who is already familiar
with family/personal circumstances that may affect
treatment decisions?
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Is there someone who is willing to
participate in health care decisions on your behalf as
your advocate and conscience?
-
Is there someone who is able to act on
your behalf considering that person’s age, location and
availability?
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Is there anyone able to make tough
decisions should it become necessary to do so?
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Is there anyone who’s able to understand
important and possibly difficult medical information?
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Are you confident that your choice will
make the best decisions on your behalf consistent with
your wishes?
Specific instructions
Whatever one’s age, current health or family history, no one
knows when circumstances may arise that may render any of us
unable to participate, whether temporarily or permanently,
in critical medical decisions affecting our care. It is
essential that a variety of scenarios be considered in which
an Agent(s) may be required to act and make decisions.
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Treatments considerations:
a. Limitations regarding types of medications (if any),
including pain relief.
b. Limitations regarding surgical procedures (if any).
c. Limitation regarding nutrition and hydration
treatments (if any), including feeding tubes.
d. Limitations regarding artificial respiration (if
any), including CPR.
e. Limitations regarding alternative or experimental
treatment (if any).
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Organ donation
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Withdrawal of life support:
a. Degree of severity of condition
b. Degree of permanence
c. Degree of pain
d. Financial costs
e. Overall quality of life
Revisiting your choices
Planning is an ongoing process. It is important to regularly
examine your choices periodically and whenever circumstances
change. The list of questions should be reviewed no less
than annually, regardless of the difficulty associated with
having to confront emotionally difficult issues.
Not having a proxy is tantamount to crossing a busy
intersection, against the light, without even looking.
Once you have selected your Agent(s), prepared and signed a
proxy, then what? Unless your proxy information is available
in the event of an emergency, all the effort you have
undertaken is wasted. But there are options:
Companies like med proxy, a member of the
online-registries.com family of web
based digital medical records sites. med proxy permits the
safe, secure, simple, affordable and private storage and
retrieval of your proxy information with the ability to
access and share those records with designated healthcare
providers in an emergency, when every seconds counts.
In an emergency, med proxy offers accredited hospitals and
healthcare organizations the ability to read your proxy
information, learn the identity of your Agent(s) and how to
contact them. In addition, whenever your proxy is accessed
by a hospital, your Agent(s) will be immediately notified by
email with the name, address and phone number of the
hospital.
Only subscribers can access the data however, accredited
hospitals or anyone to whom you give your password may
access this data on a read-only basis. There is an initial
charge of $19.95 for registration, which allows members to
update or change their own information whenever they choose,
at no additional cost. There is an annual charge of $9.95.
Please keep in mind that a proxy is NOT the same as a living
will. In order to implement wishes set forth in a living
will, which most states do not recognize as binding in the
absence of a proxy Agent(s), the patient will need to
designate, in writing, an individual and usually an
alternate, to act on his/her behalf.
Although details of the laws governing medical proxies
differ from state to state, Agents may act only after the
attending physician certifies that the patient is unable to
make or communicate decisions. The Agent may then make any
decision that a patient would otherwise make, such as
consent or refusal of medical treatment.
The patient can, in advance, issue specific instructions and
stipulate exceptions to the Agent’s authority.
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