Although many are aware of advance directives, there is often confusion as to the difference in various estate planning documents used either at the end of life or in connection with medical decisions.
The following is a brief description of this variety of documents and usage:
1. Living Will (Directive to Physicians). Most are familiar with this document which permits the cessation of life if the one who signs the document (a) is terminally ill (expected to die within six months as determined by your doctor) even with life-sustaining treatment or (b) has an irreversible condition such as a persistent vegetative state. There can be specific decisions such as whether one desires artificial food and water, blood transfusions, antibiotics, dialysis, surgical procedures, or even if you want to be on a ventilator among other life-sustaining options. This document is only used when the person who signed the document is no longer capable of making a decision. This document is usually used when the patient is in a hospital.
2. Out of Hospital Do Not Resuscitate Order. This document is used to instruct medical professionals (i.e., paramedics) to not resuscitate you if you stop breathing. Typically this is used outside of the hospital by the elderly or those in frail health. So, for example, paramedics would have a duty to resuscitate if you have not signed this document – even if you have signed a living will.
3. Medical Power of Attorney. This document grants someone else to make medical decisions for you when you cannot make the decisions.
4. HIPAA Authorization. As a result of the privacy laws, only you have access to your medical records. However, if this document is signed, you grant access to your medical records to those who you name if you lack medical capacity or even if you are deceased. If you granted access to your medical records in your medical power of attorney, access would cease upon your death as powers of attorney terminate at death.
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