Take control of your healthcare by expressing your desires in written documents.

By completing Healthcare Directives in advance and expressing what kind of medical treatment and healthcare you want to receive if you are unable to communicate, you take control of this important part of your life. The Idaho Medical Consent and Natural Death Act, “The Act,” endorses two documents for this purpose: a Living Will / Durable Power of Attorney for Health Care and a Physician’s Order for Scope of Treatment. These documents have far reaching implications, so you should understand how they work and when they go into effect.

A Living Will takes effect when

  1. you are unable to communicate, and
  2. you have an irreversible injury, disease or illness, and
  3. a medical doctor has certified all of these:
    • your condition is terminal
    • life-sustaining procedures would only artificially prolong your life
    • your death is imminent
  4. Or you have been diagnosed as being in a persistent vegetative state.

A Living Will only goes into effect under the above limited circumstances, but what about other times in your life when you need medical treatment and you cannot communicate your desires? The Act provides that if you are unable to consent to medical treatment, a surrogate-decision maker may make the decision for you. Individuals that can act for you, in the order of their priority, are: a court-appointed guardian or the person named as your Durable Power of Attorney for Health Care. If no one has been designated, a spouse or other family member may make decisions for you. This can lead to a conflict between family members who have differing opinions on the medical treatment or care that you should receive.

In Idaho, the Living Will and Durable Power of Attorney for Health Care are combined into one document. The Durable Power of Attorney for Health Care will go into effect if for any reason you are unable to communicate your desires concerning your care. Giving your agent authority to make decisions for you is necessary for individuals who have a chronic illness, such as Alzheimer’s, and need someone to make day-to-day healthcare decisions for them.

In the Durable Power of Attorney for Health Care you may give your healthcare agent directions as to the kind of medical treatment and healthcare that you want to receive. You should also have a conversation with your designated agent to make sure he or she is willing to act on your behalf and follow your directives.

This leads us to the third document, the Physician’s Order for Scope of Treatment (POST). The POST is a one-page document that you fill out with your doctor. Section A functions as a “Do Not Resuscitate Order.” If you do not want to be resuscitated if your heart and breathing have stopped, you would indicate this.

Sections B and C indicate your desires for medical interventions and for artificial fluids and nutrition; however, unlike a Living Will, these sections do not specify under what circumstances your desires would take effect. To avoid conflict between your Living Will and your POST, you should fill out the “Other Instructions,” (in Sections B and C) indicating under what circumstances your directives apply. For example, you might say “My directive applies if I have a terminal illness and death is imminent or if I am in a persistent vegetative state.” An alternative way to handle this issue is to defer decisions concerning your medical interventions and artificial fluids and nutrition to your agent named in your Durable Power of Attorney for Health Care.

These documents ensure that your desires will be followed. It is your life; your wishes matter.

Tom Packer is an Elder Law Attorney serving all of Southeast Idaho. As part of his law practice, Tom offers Life Care Planning to deal with the challenges created by long-term illness, disability and incapacity. If you have a question about a senior’s legal, financial or healthcare needs, please call us.