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Health & Balance

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Questions & Answers: Advance Directives and End of Life Decisions

Should I prepare a living will and also use a medical power of attorney to appoint an agent?

Yes. You can best protect your treatment wishes by appointing a healthcare agent and preparing a living will. Each offers something the other does not.

Benefits of appointing a healthcare agent.
Medical decision-making is rarely simple. Treatment decisions must be made in response to changing medical conditions, and medical situations frequently unfold unpredictably. Decision-making often involves weighing the benefits and burdens of treatments and even evaluating the odds for success or failure.

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The person whom you appoint as your agent can respond flexibly to changes or unanticipated situations in a way that no document can. In addition, you are legally authorizing that person to make decisions based not only on what you expressed in writing or verbally, but also on the knowledge of you as a person. Your agent can consider other concerns you might have, such as the effect of your illness on your family and the quality of life that matters to you.

Living wills address end-of-life decisions only. An agent appointed through a medical power of attorney usually can make healthcare decisions for you in a wider range of situations than those involving end-of-life care.

Benefits of having a living will.
If your agent must decide whether medical treatment should be withheld or withdrawn to permit you to die, your living will can reassure your agent that he or she is following your wishes. Further, if the person you appointed as agent is unavailable or unwilling to speak for you, if you have been unable to identify an appropriate agent, or if other people challenge a decision not to use life sustaining medical treatments, your living will can guide your caregivers. A thoughtfully prepared living will is a valuable supplement to appointing an agent.

What if I do not have anyone to appoint as my agent?

If you have no one to appoint as your agent, it is especially important that you complete a clear living will and that you talk about it with anyone who might be involved with your health care. This might include family members, even if you do not want one of them to be your agent. It also could include social workers, spiritual caregivers, visiting nurses, or health aides who are helping you in some context. You should discuss it with any physicians that you see regularly and give them a copy to put in your medical record. If you are admitted to a hospital or long-term care facility, you should have a copy of your living will made a part of your medical record.

WebMD Medical Reference from the National Hospice and Palliative Care Organization

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