How to Ease the Burden of End-of-Life Care Decisions

by Chris Kelly

In this third installment of our series on basic estate planning, we will examine medical advance directives (see the first two articles here and here).

Advance directives are documents used to inform family and medical personnel of a person’s final wishes as to end-of-life medical treatment. These documents can also be referred to as Living Wills or Advance Care Plans. In 2017, the Tennessee Department of Health created the Advance Directive for Health Care, which combined the elements of the Living Will, Advance Care Plan, and a Medical Power of Attorney (find the form here). 

While the other types of documents executed before 2017 are still valid in Tennessee, it is worth taking a look at the new form, as it is far superior in the scope and breadth of topics it covers. Simply stated, it does a better job than previous documents in making sure a patient’s intent is clear on a variety of health care questions. 

An advance directive becomes important when a patient is facing the end of his or her life, generally after a doctor has delivered a terminal diagnosis. While a person is competent, he or she will always be able to make his or her own health care decisions. However, if a person has been rendered incompetent for any reason, the advance directive allows the patient to communicate the types of treatments that he or she may or may not want when facing the end of his or her life. The directive can speak to whether specific measures (such as CPR, respirators, etc.) should be employed or not. It can additionally codify a person’s desire for pain medication or not. Additionally, on the Tennessee form, a person can name his or her agent to make health care decisions for him or her.

Once a person has executed an advance directive, it is advisable for him or her to provide copies to the agent (the one who is named to make health care decisions in the document) as well as to a person’s doctors and local hospital. By providing copies before they are actually needed in a moment of crisis, a person can have a conversation with these people as to what the person’s clear intentions are regarding end-of-life treatments. This ensures there is time to clarify and even re-execute documents in case the providers discover issues that prevent them from honoring the documents as presented. 

While there are some unsettled areas in this area of law in Tennessee, generally the agent cannot overturn the express wishes of the person as expressed in a properly executed advance directive. Thus, it is important to ensure your wishes are clearly expressed in it. The document not only ensures that your wishes are known, but also gives the agent and family the peace of mind that he or she is making the correct decision when the time comes. And when a family is already dealing with a crisis, giving them clarity on this decision is a gift beyond measure. 

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Please note that the advice offered in this article is not intended to be construed as tax, legal or accounting advice. This material has been prepared for general informational purposes only and is not intended to provide, and should not be relied on for, tax, legal or accounting advice for the reader. You should consult your own tax, legal and accounting advisors before engaging in any transaction.

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