Your living will (health care directive) is the place to write out what you do and do not want in terms of medical care if you are unable to speak for yourself. You don't need to become a medical expert to complete your document, but it will help you to become familiar with the kinds of medical procedures that are commonly administered to patients who are seriously ill.
Life-Prolonging Medical Care: In Minnesota health care directives ask you whether or not you want to receive life-prolonging treatments at the end of life if you are in a terminal condition. Such procedures typically include:
transfusions of blood and blood products
cardiopulmonary resuscitation (CPR)
administration of drugs
use of a respirator, and
If you want more information, you can discuss these treatments with your doctor or a patient representative at a hospital or health insurance plan office, or you can ask attorney Ed Gross for help with making these decisions.
Food and Water: If you are close to death from a serious illness or are permanently comatose, you may not be able to survive without the administration of food and water. Doctors will use intravenous (IV) feeding or tubes to provide you with a mix of nutrients and fluids if you are temporarily not able to swallow. IV feeding, where fluids are introduced through a vein in an arm or a leg, is a short-term procedure. Tube feeding, however, can be carried on indefinitely.
When you make your health care documents, you can choose whether you want artificially administered food and water withheld or provided. This decision is difficult for many people. Keep in mind that as long as you are able to communicate your wishes, by whatever means, you will not be denied food and water if you want it.
Palliative Care: (Pain Relief) If you want death to occur naturally -- without life-prolonging intervention -- it does not mean you must forgo treatment to alleviate pain or keep you comfortable. This type of care, sometimes known as "comfort care" is now more commonly called "palliative care."
Rather than focusing on a cure or prolonging life, palliative care emphasizes quality of life and dignity by helping a patient remain comfortable and free from pain until life ends naturally. Palliative care may be administered at home, in a hospice facility, or at a hospital.
You may wish to spend some time educating yourself about palliative care. You can include your feelings and preferences about such care in your living will.
The Minnesota Health Care Directive allows and empowers your agent the authority to make all health care decisions for you unless you specifically place limits on that authority in the document. This means that your agent will normally be permitted to:
consent or refuse consent to any medical treatment that affects your physical or mental health (there are usually exceptions to this rule for situations such as extreme psychiatric treatments and termination of pregnancy, and your agent is not permitted to authorize any act that violates the wishes you've stated in your living will)
hire or fire medical personnel
make decisions about the best medical facilities for you
visit you in the hospital or other facility even when other visiting is restricted
gain access to medical records and other personal information, and
get court authorization, if required to obtain or withhold medical treatment, if for any reason a hospital or doctor does not honor your living will or the authority of your health care agent.
Organ Donation and Body Disposition: Most of your agent's authority under the Health Care Directive will end upon your death. However, you can give your agent permission to oversee the disposition of your body, including authorizing an autopsy or carrying out your wishes for organ donation. If you want your agent to have these powers, you should say so in your document.
If you have specific wishes about these matters, your living will is a good place to write them down. Your agent is legally required to follow your instructions whenever possible. (For more information, see The Organ Donor: A Guide or Donate Your Body to Medicine.)
Limiting Your Health Care Agent's Authority Keep in mind that as long as you are able to understand and communicate your own wishes, your agent cannot override what you want. Your agent steps in only if you can no longer manage on your own.
In addition, as mentioned, you are permitted to restrict your agent's authority in any way that you like. For example, some people give their health care agent only the authority to carry out the health care wishes specified in their living will, and not to make other medical decisions for them.
Think carefully, however, before you add limiting language to your power of attorney. One of the most important reasons for appointing a health care agent is so that someone will be there to respond to the needs of your situation as it develops. Your medical needs may change in ways that you cannot now foresee, and an agent who has full power can act for you no matter what the circumstances.