Estate Planning – Medical Advance Directives

Medical Advance Directives in Estate Planning

One often overlooked area of planning is that of advance medical planning. These are documents in which you can express your wishes to your family and medical care givers. The following are typical:

Medical Durable Power of Attorney. This document appoints an agent to make medical decisions for you in the event you lack legal capacity to express your desires. Typically, a person appoints his or her spouse or adult child. This document usually has a very broad grant of authority. The agent gains the authority only after the principal has lost legal capacity. This document can be drafted with “customized” limitations to the agent’s authority.

Declaration as to Medical Treatment (Living Will). This document provides in advance for the cessation of active medical treatment for a person when certain specific conditions are met. A person must have an irreversible or terminal condition and be in a persistent vegetative state in order for this directive to be effective. These conditions must be certified by two physicians. Upon satisfaction of those conditions, the living will directs that further medical procedures cease.

HIPPA Release. This document is effective immediately and grants a spouse or other trusted person access to medical records.

Medical Order for Scope of Treatment (MOST). This document must be prepared with the assistance of a physician, advanced practice nurse or physician assistant. This is normally used at a stage of life when further treatment may not be desired. It can include “do not resuscitate” orders.

Other Directives. You may see other documents such as the “Five Wishes” or similar documents. These often contain simplified versions of the directives described above, along with other instructions.