Living Will v Heath Care Proxy v Medical Directives are all different documents…?

The most common types of advance directives are the living will and the durable power of attorney for health care (in Massachusetts a ”health care proxy”).

These directives allow you to say you don’t want to be resuscitated, you want to make organ or tissue donations, and desired quality of life and end of life treatments you don’t want to receive.

You also can include instructions for other situations, such as if you are unconscious for a short time, or impaired by Alzheimer disease or a similar condition.

I should note that choosing not to have aggressive medical treatment is different from refusing all medical care. A person can still get antibiotics, nutrition, pain medicines, and other treatments, but the goal of treatment becomes comfort rather than cure. It is important to make clear exactly what you want and don’t want.

The living will is a formal legal document that must be written and signed by the patient. Rhode Island does have a model form and the document must be witnessed.

The witnesses cannot be spouses, potential heirs, doctors caring for the patient, or employees of the patient’s health care facility.

A living will can include:
• the use of equipment such as dialysis machines or ventilators
• do not resuscitate orders, DNR and use of CPR
• tube feeding - fluids and/or nutrition
• treatment for pain, nausea, comfort care
• whether you want to donate your organs

A living will is more limited than a health care power of attorney – health care proxy. Both apply when you are unable to speak for yourself, but the living will takes effect only if you are terminally ill or permanently unconscious.

In a durable power of attorney for health care, you name a person to be your agent (proxy) to make all your health care decisions if you become unable to do so. The agent should be someone you trust to carry out your wishes.

Even though your living will attempts to set out your wishes, such documents can never cover every circumstance. The durable power of attorney for health care is there to fill in gaps for situations not covered or in case your living will is invalidated for any reason.

Typical rights and/or duties of an agent would include:
• providing medical decisions that are not covered
• enforcing healthcare wishes in court if necessary
• hiring and firing doctors and medical workers
• having access to medical records
• visitation rights

You should give a signed copy of both to your doctor and your agent.