When does my healthcare directive take effect?

Your healthcare directive becomes effective when three things happen:

• you are diagnosed to be close to death from a terminal condition or to be permanently comatose
• you cannot communicate your own wishes for your medical care -- orally, in writing or through gestures, and
• the medical personnel attending you are notified of your written directions for your medical care.

In most instances, you can ensure that your directive becomes part of your medical record when you are admitted to a hospital or other care facility. But to ensure that your wishes will be followed if your need for care arises unexpectedly or while you are out of your home state or country, it is best to give copies of your completed documents to several people, including your regular physician, your healthcare proxy and another trusted friend.

Who should I choose as a healthcare proxy?

The person you name as your healthcare proxy should be someone you trust -- and someone with whom you feel confident discussing your wishes. While your proxy need not agree with your wishes for your medical care, you should believe that he or she respects your right to get the kind of medical care you want.

The person you appoint to oversee your healthcare wishes could be a spouse or partner, relative or close friend. Keep in mind that your proxy may have to fight to assert your wishes in the face of a stubborn medical establishment -- and against the wishes of family members who may be driven by their own beliefs and interests, rather than yours. If you foresee the possibility of a conflict in enforcing your wishes, be sure to choose a proxy who is strong-willed and assertive.

While you need not name someone who lives in the same state as you do, proximity should be one factor you consider. The reality is that the person you name may be called upon to spend weeks or months near your bedside, making sure medical personnel abide by your wishes for your healthcare.

You should not choose your doctor, or an employee of a hospital or nursing home where you are receiving treatment. In fact, the laws in many states prevent you from naming such a person. In a few instances, this legal constraint may frustrate your wishes. For example, you may wish to name your spouse or partner as your representative, but if he or she also works as a hospital employee, that alone may bar you from naming that person. If the law in your state bans your first choice, you will have to name another person to serve.

What types of medical care should I consider when completing my healthcare documents?

Technological advances mean that currently unfathomable procedures and treatments will become available and treatments that are now common will become obsolete. Also, the treatments that are available vary drastically with region, depending on the sophistication and funding levels of local medical facilities.

While putting together your healthcare directive, the best that you can do is to become familiar with the kinds of medical procedures that are most commonly administered to patients who are terminally ill or permanently comatose. Those most commonly administered include:

• blood and blood products
• cardio-pulmonary resuscitation (CPR)
• diagnostic tests
• dialysis
• drugs
• respirators, and
• surgery.

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DISCLAIMER: This site and any information contained herein are intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.

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