Advance Directives: Living Wills, Health Care Powers of Attorney, and Do Not Resuscitate Orders

Market Memo – Planning Article

May 2023 – By Tom Rueger, J.D., CFP®

In general, an Advance Directive is a document that instructs others about your preferences for medical care if you are unable to make decisions on your own or unable to communicate your wishes to others. Advance Directives can give instructions on your preferences regarding the decisions of doctors and caregivers if you are terminally ill, seriously injured, in a coma, in the late stages of dementia, or near the end of life.  They only become effective under the circumstances stated in the document. Advance Directives can communicate the treatment that you want and don’t want. They can help avoid unnecessary suffering, reduce confusion or disagreement, and relieve caregivers from the burdens of making decisions.  An Advance Directive does not remove any decision-making authority from you while you are still competent since you can always override any decision or revoke any Directive that you have made.

Living Will

A Living Will is a written legal document that outlines the specific medical treatments that you want and does not want. This includes end-of-life decisions such as CPR, mechanical ventilation, tube feeding, and dialysis, as well as pain management, organ donation, and other medical preferences.

Durable Health Care Power of Attorney

A Durable Health Care Power of Attorney is a written legal document in which you give another person the power to make health care decisions for you when you become unable to make decisions yourself. This person that has decision-making authority granted to them can be referred to as an agent, a proxy, a surrogate, a representative, an advocate, and an attorney in fact. The word “Durable” means that the decision-making power that is granted to another will continue throughout your incapacity.

Do Not Resuscitate (DNR)/Do Not Intubate (DNI)

A DNR is a medical “Order” that tells medical professionals that you do not want to be resuscitated via CPR or other similar lifesaving measures. A DNI is a medical “Order” that tells medical professionals that you do not want a breathing tube inserted when you can no longer breathe on your own. You will need to communicate your desires to your doctor, and the doctor will write the orders and make them a part of your medical record. A DNR/DNI is not official unless the doctor signs off on the document. Even if you have an Advance Directive that includes your preferences regarding resuscitation or intubation, it is still a good idea to establish a DNR or DNI each time you are admitted to a new hospital or healthcare facility.

Physician Order for Life-Saving Treatment (POLST)

A POLST (sometimes referred to as a Medical Order for Life Saving Treatment/MOLST) is used in some states when a person has already been diagnosed with a serious illness. It does not replace other Advance Directives but serves as doctor-ordered instructions, more like a prescription, to ensure that you receive the treatment that you discussed with your doctor. A POLST (or MOLST) stays with you whether you are in a nursing home, hospital, or your own home and is displayed near your bed where all medical personnel can easily find it.

Things to Consider:

  • Keep the originals of your Advanced Directives safe but easily accessible.
  • Give a copy of any Advanced Directive to your doctor, your health care agent, and any successor agents.
  • Talk with your family members about your Advanced Directives and your specific healthcare wishes.
  • Keep a copy of any Advanced Directives with you when you are traveling.

The rules and requirements for Advance Directives can differ from state to state. Therefore, we recommend that you use an attorney to help you in thinking through and drafting these documents. If you would like to know more about estate planning or need help finding a qualified attorney, please contact your Wealth Advisor and they can assist you.

This material is for informational purposes only. It is not a recommendation or solicitation to buy or sell any securities.  Vantage Financial is not a tax advisor or estate planning attorney; please consult your tax advisor or estate planning attorney prior to making any decisions.  Vantage Financial is an Investment Advisory Firm registered with the Securities and Exchange Commission (“SEC”).  SEC registration does not imply any particular level of skill or expertise.