Sunday, January 13, 2008

How to Write a Health Care Proxy Document


A health care proxy, known as a "living will," "advance directives for health care" or a "durable power of attorney for health care," is a legally recognized document that reflects your medical treatment wishes. Without such a document of intent, the decision to keep an incapacitated patient alive by extreme measures could be left to the state. While such a subject may difficult to consider, preparation can save your family the pressure of stressful decisions in the future.


Difficulty: Easy



Step One

Get a form. Health care proxy forms are available in stationery stores and online. It isn't necessary to have these forms prepared by a lawyer. Although you can use the sample forms as written, they also serve as guidelines if you want to develop your own.

Step Two

Think about what you want. An "advance directive" spells out your wishes as far as the kind of medical care you do or don't want.

Step Three

Choose someone to whom you can give the legal authority to make medical decisions if you are unable to decide for yourself. The proxy directive, also called a "durable power of attorney for health care," names the individual you have chosen. Naturally, you must consult with this person to be sure that they understand and are willing to accept this responsibility.

Step Four

Spell out the specific medical treatments you wish to accept or refuse in an instruction directive, or "living will."

Step Five

Consider a combined directive. This is a single document that both spells out treatment and names the proxy.

Step Six

Don't worry--the proxy is in effect only as long as you are unable to make these decisions. Should you regain this ability, you can make your own decisions. You can change or update a directive at any time and also have the power to revoke it.

Step Seven

State clearly in the form that if you are unable to give directions about your care, your family and physicians must honor the directive. The declarant must also state that he or she is legally competent to prepare the directive.

Step Eight

Spell out such decisions as situations that would lead to DNR (Do Not Resuscitate) and forgoing life-sustaining treatment. Of course, your directive can also request that such treatments be used, as well as refused. In that case, the directive should state that artificially provided fluids and nutrition should be provided, to the extent appropriate.

Step Nine

Address such issues as artificially provided fluids and nutrition, CPR, life-sustaining measures including mechanical or artificial means, terminal condition meaning an irreversibly fatal illness, permanent unconsciousness--meaning vegetative state or irreversible coma and permanent vegetative state, in which a patient may be kept alive by artificial means, incurable and irreversible disabling diseases such as Alzheimer's and brain death.

Step Ten

Provide instructions for such specific situations as withdrawal or withholding of specific treatments, the medical conditions under which the patient's wishes must be implemented and any other special considerations.

Step Eleven

Include organ donation instructions.

Step Twelve

Have the documents signed and notarized in the presence of 2 witnesses, neither of whom can be the designated proxy or alternates. The witnesses can't be related by blood or marriage to the person making the proxy, entitled to any portion of that person's estate, an attending physician or a person who has a claim against the declarant. Copies of the documents should then be given to the person named as representative, to family members and to the declarant's physician. If the patient is about to be hospitalized or enter a nursing home, the documents should be presented and become part of the patient's record.

Tips & Warnings

  • Your proxy should understand that he or she is responsible for carrying out your wishes, even if others disagree. The proxy document should also name one or two alternate individuals, in case the original is unable to serve.
  • Make sure your directive states your true wishes. If you prefer not to be kept on life support if you suffer from an incurable condition, you should state that two or more physicians must determine that you are in terminal condition, and if life sustaining procedures would only serve to delay the moment of death, then such heroic measures should be withdrawn and the declarant (you) should be allowed to die.

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