Duty to Obey Advance Health Care Directives

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 What Is an Advance Directive?

An advance directive specifies an individual’s wishes if they become incapacitated or unable to express wishes for health care and other treatments. Federal law mandates that any facility receiving Medicare or Medicaid reimbursements must use advance directives when specified. The majority of the states have regulations regarding formalities on witnessing signing requirements.

Although the states can have specific forms for the advance directives, the physicians have a legal duty to respect a patient’s communicated treatment wishes in any manner or form expressed, as long as the wishes are medically appropriate.

The forms are more complex and require some multiple-choice options that may not cover all the clinical circumstances you might face in the future. The main purpose of an advance directive is to clarify the values, goals, and wishes that you want others to follow if they must make decisions on your behalf. The priority is for them to adhere to your medical preferences rather than trying to address every possible medical treatment.

However, if the advance directive suggests following a procedure that the doctor believes is not medically appropriate, they can object to it. However, the doctor is still obliged to provide you with another doctor or transfer you to their treatment. The advance directive is considered legally binding, and if it is not adequately enforced, there will be legal repercussions.

Advance directive laws grant doctors and others immunity if they follow your valid advance directive. It is crucial to discuss your medical values and wishes with your healthcare providers before any treatment. This protects your health and allows you to effectively communicate your stance regarding your healthcare.

The legal document also serves as a way to explicitly express what you want and do not want when it comes to care. You can further address in your advance directive your emotional, social, and spiritual needs for any treatment.

Having transparency in your communications with the doctor and family is considered the initial step. However, do not assume that each term outlined in the advance directive will be automatically adhered to. The lawyer may suggest combining talking and documenting for the best results in compliance with the agreement.

Knowing certain aspects of healthcare can be useful when deciding on these topics. Therefore, consulting with a healthcare professional before deciding your treatment path will be beneficial. Provide copies to the crucial parties for your care.

There is a pathway to proceed with formulating your medical advance directive. First, you can discuss your wishes with your physician and how they will be legally able to carry them out. Second, your advance directive doesn’t need to be available in your medical records. You need to be proactive and ensure it is transferred to the correct facilities. If you are unable to do this on your own, make sure to appoint a proxy to handle this for you.

Lastly, drafting and creating your advance directive is a process. You can keep the following guidelines in mind when writing it:

  • You are aging;
  • You experienced a close death in the family;
  • You divorce;
  • You are diagnosed with a severe medical condition;
  • There is a decline in your medical condition.

What Is Included in an Advance Directive?

Certain provisions must be included in an advance directive that details medical decisions for you in case you are unable to make them yourself. The specific healthcare directions provided will be given to others so they can make decisions as needed.

A living will, as stated above, is a legally binding document. The parties responsible for carrying out the procedures must abide by the medical preferences. If the healthcare provider does not want to carry out certain procedures, then they must transfer the care to another physician, as written earlier. A living will direct health care providers to refrain from certain medical or surgical treatments.

For medical treatment, a terminal condition is considered an incurable, irreversible medical condition in an advanced state caused by injury or illness. This particular vegetative state may result in death regardless of the continued application of life-sustaining treatment.

However, the medical certainty of a certain condition can vary among the doctors, too. But in general, terminally ill patients should think about drafting an advance medical directive to meet their treatment plans.

Moreover, having a durable power of attorney for these situations is a good way to ensure that your medical needs are being addressed. This document essentially appoints in writing another person (an agent) who will be able to carry out healthcare decisions on your behalf if you cannot do so yourself.

The assigned healthcare agent holds broader power to execute your wishes than can be provided under a living will. Therefore, it is necessary to carefully choose your agent to ensure that they will comply with your requirements.

Lastly, health care instructions are another type of written advance directive that can be utilized alone or together with the appointment of a health care agent. Health care instructions can specify your medical preferences for situations such as if you are in a terminal condition, persistent vegetative state, or end-stage condition.

Further, you can communicate other healthcare decisions, such as do-not-resuscitate (DNR) orders, organ and tissue donation, and special instructions for dialysis, as well as blood transfusions. These can all be included in your advance directive, along with other health information you deem necessary.

How Do I Make an Advance Directive?

There are some general guidelines to follow to have your advance directive wishes issued. As mentioned above, you should have open communication with your physician, family, and other interested parties regarding medical treatment and health care. Each state has forms that can be accessed online to initiate the process of drafting an advance directive for your medical care.

If you have further questions regarding the process and how to legally create an advance directive, then you can reach out to a lawyer to discuss a pathway for you. Each jurisdiction has its own rules, and you can search your local state to determine what works for you.

Will an Advance Directive Guarantee Your Wishes Are Followed?

An advance directive is legally recognized but not legally binding. Your healthcare provider and proxy will do their best to respect your advance directives, but there may be situations in which they cannot follow your wishes completely. For instance, you may not be able to foresee some situations and become unsure about the treatment you want. For this reason, it is crucial to set up a plan that does allow you to make adjustments as medically needed.

There will be scenarios that may occur against your wishes. This may occur if the decision goes against:

  • The physician or healthcare provider’s conscience;
  • The health care institution’s policy in general;
  • Accepted health care standards.

If this happens in your case, you do have a right to have your case transferred.

When Do I Need to Contact a Lawyer?

Advance Healthcare directives are crucial in cases where a patient wishes to express their preference for their medical treatment but is unable to due to an incapacity. Planning for a medical advance directive in place allows you the freedom to choose the type of medical care you wish. However, there may be situations where the physician may not agree to your specified medical care because of other viable reasons.

If you have questions regarding the enforcement of your medical advance directive, you can reach out to a local elder lawyer to assist you with it. LegalMatch can connect you with an attorney in your area who can help you with your legal needs.

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