So far, we have discussed selecting who would take care of your minor children and who would take care of financial issues.  This week we will discuss who will be in charge of making health care decisions if you are unable to do so for yourself.

Choosing a health care agent is a deeply personal one.  I have obtained some great insights from clients who have been through end-of-life with a loved ones.  They have shared with me heart-wrenching details regarding what went right and what went horribly wrong.  I will share some of the wisdom they shared with me. 

The person you choose to make health care decisions for you is designated in your Health Care Power of Attorney, Living Will or Advance Directive.  Keep in mind that these documents can not be used to override your wishes as long as you can communicate them for yourself and as long as you are competent.  A word to clear up the differences in these documents is in order.  A Health Care Power of Attorney is a document where you give a specific person the authority to make medical decisions in any situation where you can not do so for yourself.  This covers end-of-life situations like terminal illness and health crises where you are expected to fully recover like a car accident.   A Living Will is a document that conveys to the world only your end-of-life wishes and hopefully gives someone the authority to carry them out.  This is where you decide if you want life-support and if so, what type.  An Advance Directive combines the Health Care Power of Attorney and Living Will, spelling out your wishes and who is entitled to carry them out.  

Choosing the proper person to name in these documents should be carefully considered.  Keep in mind that these documents will be used in a medical crisis. You need to consider the disposition of the person you are selecting.  These documents are used in a highly emotionally-charged atmosphere.  Does the person you want to designate fall apart in an emergency?  You should also consider their willingness to carry out your end-of-life wishes.  If you and your health care agent disagree about life-support will he or she over-ride your wishes?  You should know, your health care agent is not bound to respect your treatment preferences.  The health care agent is tasked with taking into account your preferences and weighing them against the facts available at that time in order to make a decision about your care.  Also, consider whether your health care agent would be so grief-stricken that he or she would be unable to take you off life support if that is your wish.  And, finally, is your health care agent someone who can get your loved ones to agree in times of trouble or is he or she more likely to start a fight?     The best way to find the answers to these questions and select the right person is to discuss it with your first choice and second choice (always designate at least one back-up agent just in case).  If after discussing your wishes you are not satisfied move on to your third choice and so on until you find someone who understands and respects your wishes and would be able and willing to carry them out. 

As a side note, if you have a Health POA, Living Will or Advance Directive and they are old, you should get them updated to cover issues related to HIPAA (the relatively new, federal law regarding privacy in medical records).   In an emergency, your health care agent will need access to your medical records in order to make an informed decision and in an emergency, you will not be available to sign the release. 

I hope you found this series useful and you have used this opportunity to have some frank discussions about your wishes with your loved ones.