Determining your own medical decisions in uncertain times
By Elizabeth W. Abel, J.D., LL.M. (Taxation)
One of the most important documents any one of us can have, but especially during these times of pandemic, is an advance directive for healthcare (ADHC). An ADHC is a document which allows you to direct your medical care and decision making.
Anyone who is at least 19 years of age can sign one, and every ADHC terminates upon your death. An ADHC has two parts: a living will and a medical power of attorney.
The living will section of an ADHC allows you to specify whether you do or do not want life-sustaining treatment if you have been diagnosed by two physicians to be either terminally ill or injured, or to be permanently unconscious. A person is "terminally ill or injured" if two doctors who have examined you certify that you have an illness or injury that will cause your death in 60 days or less. A person is "permanently unconscious" if two doctors certify that you are brain-dead, it is not expected you will recover from that condition, and that condition is expected to last for more than 60 days.
The term “life-sustaining treatment” encompasses a variety of treatments such as CPR, artificial respiration, etc. If, however, the treatment that is keeping you alive is tube-feeding or tube-water (because you are unable to swallow and a tube has to be inserted to provide you with nutrition or hydration), then you have to specifically say whether you want or do not want that life-sustaining treatment.
The living will section also allows you to specify other directions you would like to be followed or that you would like the medical providers to be aware of. For example, such directions might include drugs or medical procedures you do or do not want, or doctors you would like to be consulted or utilized in your care. Some clients also like to make directions about organ or tissue donation in an ADHC.
The second part of an ADHC is the healthcare proxy appointment, where you appoint someone to make medical decisions for you only if you are unable in any way to communicate those decisions in some form or fashion. You can appoint one person as healthcare proxy, or several persons to serve together. You can appoint one or more alternates to serve in the event the first named proxy stops serving at any time.
Your proxy can make decisions on your behalf regarding the thousands of medical decisions that could arise, as well as decisions regarding life-sustaining treatment. You can specify that the decisions which you specified in the living will section of your ADHC will control over the decisions of the proxy, or you can direct that those specified decisions will just be guidelines for your proxy.
Under Alabama law, the decisions made in an ADHC to refuse or remove life-sustaining treatment does not constitute suicide. Also, if a physician or medical facility does not want to follow those decisions, then it must turn you over to another physician or facility which will follow them. An ADHC is critical to have to preserve your ability to direct your medical care, even when you are unconscious or unable to communicate. I hope you will consider having an ADHC prepared so your medical decisions can be documented and carried out.