Every individual should have documents such as a Health Care Proxy, Living Will, Do Not Resuscitate (DNR) and/or Do Not Intubate (DNI), and Practitioner Orders for Life-Sustaining Treatment (POLST) in place to assist loved ones who may need to make medical decisions on their behalf, including end-of-life decisions. A brief overview of the purpose of each document can be found below.
Health Care Proxy
A health care proxy is a document that allows an individual, the agent, to make medical decisions on another individual’s behalf if a doctor concludes that he or she is unable to make these decisions for themselves. An agent can only make decisions about artificial hydration and feeding (nourishment and water provided by a feeding tube or intravenous line) if he or she knows the patient’s wishes from what they said or have written. For this reason, is imperative that the document indicates whether or not the agent is permitted to allow or refuse hydration or feeding. A health care proxy should list at least one successor agent in case the initial agent is unavailable, unable, or unwilling to make such decisions.
A living will is a legal document that provides evidence of an individual’s wishes for medical treatment or life support. A living will is usually signed along with a health care proxy. This document can outline an individual’s acceptance or refusal of treatments, such as artificial nutrition and hydration, antibiotics, cardiac resuscitation, mechanical respiration, blood transfusions, or surgery, among others. Although someone other than a lawyer can prepare a health care proxy and living will, it is not recommended. An experienced estate planning lawyer will include more extensive language in these documents.
Do Not Resuscitate (DNR)
A Do Not Resuscitate (DNR) form is orders signed in a hospital or other facility that apply only to cardiac respiratory arrest. It directs the facility that no chest compression, defibrillation, ventilation, or intubation be administered. An individual or acting agent can consent to a DNR. Additionally, it is issued by a physician and on a Department of Health form.
Practitioner Orders for Life-Sustaining Treatment (POLST)
The Practitioner Orders for Life-Sustaining Treatment (POLST) form allows a patient to indicate their wishes regarding life-sustaining treatment. The form, executed by a patient’s physician or advanced practice nurse, provides guidance for health care professionals to follow for a range of life-sustaining treatments. The POLST form follows an individual from one health care setting to another, including hospitals, nursing homes and hospice. For instance, if someone is transferred from a nursing home to a hospital, the form will follow them to ensure that his or her wishes are properly conveyed.
It is important that wishes for medical treatment, or withholding of treatment be discussed with family and agents. Additionally, after these documents are executed, it is important to continue to have conversations with loved ones regarding your wishes as they may change.
The New Jersey estate planning attorneys at Hunziker, Jones and Sweeney, P.A. can provide assistance in putting your legal, financial, and medical affairs in order to avoid legal complications requiring court intervention. For more information or to schedule a consultation, call our New Jersey estate planning law firm at (973) 256-0456 or fill out our contact form.