Advance directives have been a popular part of estate planning since at least 1990, when Congress passed the Patient Self-Determination Act. Since then, Americans have only grown stronger in their sentiment that they should decide for themselves what kind of treatment they’ll receive in the face of terminal illness.
Advance directives can be very specific and are generally quite effective, legally speaking — provided they’d been properly executed.
But what happens when doctors or hospitals misplace, misinterpret, or simply ignore an advance directive? It happens more often than you might think.
The New York Times recently told of a man who properly executed a healthcare directive before his dementia rendered him unable to communicate. His instructions were clear enough: in the event of any life-threatening condition, doctors were to provide “comfort care only, no heroics.”
But when his nose began to bleed without cessation one day, accompanied by blood in his vomit, doctors in the hospital apparently took extraordinary action to save him — three surgeries, including a tracheotomy, which put a hole in his throat and a feeding tube in his stomach.
It wasn’t until then that the healthcare providers noticed his advance directive. There is no evidence that the hospital willfully ignored the patient’s instructions, but the practical effect is the same — he’s back in a nursing home and breathing on his own again, but feeling the effects of a procedure he never wanted.
So how can you make sure that your own advance directive is honored, whatever its terms may be? We have three tips:
- Distribute — Give a copy of your healthcare directive to close family members or friends you trust, share it with your doctors and your local hospitals, and keep a copy somewhere that’s easily accessible near the front door of your home.
- Communicate — Let the important people in your life know what your wishes are. Don’t simply assume that they’ve read the details of your advance directive or that they remember what it is. Remind them, have a conversation about the sincerity of your wishes, and confirm that they intend to honor it. And, if you’re able to communicate when in a hospital, remind doctors and nurses too.
- Specify — Too many advance directives use vague or overly “legal” language that won’t mean much to doctors. Physicians make decisions using precise medical terms, and they sometimes need to make decisions in a split second. Crystal-clear and highly specific drafting can make all the difference.
If you need help drafting an advance directive of your own, the Middlesex County estate planning attorneys at O’Connell Law, LLC can help. We’ll work closely with you to make sure we understand exactly the plans you have in mind, however precise they may be. We’re here to help.
