It is unfortunate but is a common reality that misunderstandings about the documents that are designed to guide end-of-life decisions happen frequently. There are many documents available to a person to help them make end-of-life decisions and they don’t all work the same. Additionally, they shouldn’t all be treated the same. There are vast differences between a do-not-resuscitate document commonly known as a DNR, a living will, and a Physician Order for Scope of Treatment or POST instruction form. Our goal as the premier Idaho estate planning firm is to help our clients understand these differences and to guide them in deciding which form or combination of these forms will work best for them as they consider their own end-of-life decision-making.
At the Racine Firm our team of Idaho talented estate planning attorneys have helped clients for more than 70 years complete their own customized Idaho estate plans. Because no two people are alike, no to estate plan should be a like either. Rather, each estate plan should be customized to the needs of the individual who creates it. Our team of Idaho estate planning attorneys is made up of partners Randy Budge and Lane Erickson and attorneys Nate Palmer and Dave Bagley, who all understand the importance of customizing estate planning for each of our clients.
When it comes to making end-of-life decisions, and deciding which forms a person should use, there are several things that each individual should understand. Below is a discussion of the several types of forms that are available and a description of what each of these forms can do.
A Living WillA living will is a specialized end-of-life decision-making document that fills a very specific need. The important thing to understand is that a living will is not a binding medical order, because it leaves some room for your physicians to make an interpretation about your current health situation.
For a living will to become binding, there are three specific criteria that must be met and it is your physician that decides whether these criteria exist. The first is that you have a terminal condition. Essentially what this means is that you have a condition that is going to lead to your death and there is really no hope of any type of recovery from this condition. This condition could be caused by either an illness or an injury.
The second criteria is that your death is imminent. In other words, the terminal condition that you have will result in your death within a short period of time unless you are placed on life support systems. In that instance the life support systems would only be keeping you alive artificially.
The third and most important criteria is that you personally are unable to communicate with your physician about your wishes. In other words, you either are unconscious, or due to a mental disability or infirmity you are unable to understand your condition and communicate with your physician about what your decisions are concerning your medical treatment.
These criteria are important. It’s also important that your physicians consider these criteria. Take for example a 46 year-old woman who is brought into an emergency room because of a heart attack. Assume that she goes into cardiac arrest. In all other respects she is healthy. She has a living will that states that she does not want to be kept alive artificially. In this instance, the living will really has no bearing on the treatment of her by the physicians in their efforts to try to save her life. Because a cardiac arrest is not necessarily a terminal condition, the physician should not consider the living will and should make every effort to keep her alive.
A DNR (Do not Resuscitate)A DNR or Do-Not-Resuscitate document is far different than a living will. A DNR is a legal order written either in the hospital or on some other legal form that requires the treating EMT’s or physicians to withhold cardiopulmonary resuscitation or other advanced cardiac life support procedures. A DNR does not affect any other type of health treatment that a patient would require or normally receive including intubation or CPR. Individuals who have a DNR generally continue to receive chemotherapy, antibiotics, and other appropriate medical treatments.
It is possible for a person to have both a living will and a DNR. The reason for this is because they are treated differently and they involve different situations medically.
A Physician Order for Scope of Treatment (POST)Likewise, a Physician Order for Scope of Treatment (POST) form is a different medical document that is used for purposes of end-of-life decision-making in that fills a need not met by neither a living will or a DNR document. A POST form is a set of medical orders for a patient who is usually expected to die within a year or less that is signed by a treating physician, physician’s assistant or nurse practitioner.
While POST forms vary by state, they are generally meant to be prepared and signed by the individual after they have met with their doctors. Normally, the treating physician has a detailed conversation with a patient about their medical conditions, their prognosis, their specific values and goals, the various treatment options that are available, and the potential benefits and harms of each treatment option. Based on this conversation and any other meetings that are had between the doctor and the individual the individual is able to make a decision about what information should be included in the POST form.
While the use of a POST forms is fairly new, they are becoming more common all the time. In many living will documents there are references to whether the individual also has a POST form that is signed and should be incorporated into the living will as a part of the treatment plan for that individual.
Regardless of what kind of end-of-life decision-making forms you want to use, you have the ability to make your own decisions about the end of your own life. In order to make these decisions an individual must understand the forms that are used and are available to them. Also, an individual should consult with a qualified attorney to help them appreciate and understand what each of these forms can do for them before they make any of these decisions. We have helped numerous clients through this decision-making process and we are confident we can help you too.
Enlist an Idaho Estate Planning and Probate Attorney to Help YouOur experienced Estate Planning team of attorneys can help you and your family with your Idaho estate plan or with your probate needs. Whether you are seeking your own customized Estate Plan or are in need of a Probate for a loved one who has passed, we are available to discuss your options and answer your questions at an initial consultation. Call us toll free at 877.232.6101 or 208.232.6101 for a consultation with the Racine Olson team. You can also email us directly at racine@racinelaw.net. We will answer your questions and will help you solve your Idaho Estate Planning and Probate problems.