[WSBAPT] Clients want to name children in Health Care Directive
Lisa Schuchman
lisa at lisaschuchman.com
Mon Mar 9 12:13:48 PDT 2015
Good summary, Heather. Thanks.
Lisa E. Schuchman
206-325-2801
www.lisaschuchman.com<http://www.lisaschuchman.com/>
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From: wsbapt-bounces at lists.wsbarppt.com [mailto:wsbapt-bounces at lists.wsbarppt.com] On Behalf Of Heather deVrieze
Sent: Monday, March 9, 2015 12:01 PM
To: WSBA Probate & Trust Listserv
Subject: Re: [WSBAPT] Clients want to name children in Health Care Directive
A medical directive (Advance Directive, Living Will) is a patient’s written expression of their desire to refuse medical treatment that will merely serve to artificially prolong the process of dying. It is a more general (not incident or diagnosis specific) statement that the patient does not want their lives artificially prolonged. I find facilities and medical personnel reluctant to make any medical decisions themselves based on the medical directive alone.
A medical durable power of attorney gives the patient/client the ability to nominate a medical decision maker for themselves to take effect when they cannot make such decisions for themselves. The one I prepare gives the named agent the authority to deliver and interpret the medical directive and authority to sign a DNR or POLST in the enforcement of the patient’s wishes.
First responders will generally not pay any attention to a medical directive or Durable Power of Attorney for Health Care Decisions in emergency situations, but absent a POLST will stabilize the patient and transport to hospital. The health care agent under the power of attorney, with the medical directive in hand can then work to enforce the withholding or withdrawing of life sustaining treatments at the hospital.
A POLST is “Physicians Orders regarding Life-Sustaining Treatment”. They can only be obtained through a health care provider, usually when there is a diagnosis and must be signed by the patient(or their agent) and the health care professional to be valid. A POLST is effectively instructions from a doctor to perform or not perform CPR, to provide or not provide antibiotics etc. They are most useful in emergency situations when first responders need to know what a particular patient’s wishes are.
A DNR is generally specific to the hospital or other facility and that particular hospitalization. It is a designation that is made so that all hospital personnel know how to respond if the patient stops breathing or their heart stops while they are hospitalized. It is often noted clearly on the patient chart and may also result in a sign on the patient’s door and a medical bracelet.
All of these documents have their time and place. I generally discuss DNR and POLST documents and issues with clients for whom it may be an issue, but can only provide, and do, as often as possible, the Medical Directive and Durable Power of Attorney for medical decisions.
Heather
Heather S. de Vrieze
Attorney-at-Law
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From: wsbapt-bounces at lists.wsbarppt.com<mailto:wsbapt-bounces at lists.wsbarppt.com> [mailto:wsbapt-bounces at lists.wsbarppt.com] On Behalf Of Elena Garella
Sent: Monday, March 09, 2015 11:15 AM
To: WSBA Probate & Trust Listserv
Subject: Re: [WSBAPT] Clients want to name children in Health Care Directive
I'd be curious to hear what experiences people have had with POLST versus DHCPOA. I had one case where my client had both. The docs referred to the POLST and I don't think they even looked at the DHCPOA...
On Mon, Mar 9, 2015 at 10:31 AM, Kate Gamble <uptownlawpt at gmail.com<mailto:uptownlawpt at gmail.com>> wrote:
The green sheet is the POLST form, correct?
My understanding of the POLST form is that it is a set of medical orders (thus the MD signature), which does not replace a HCD. It is voluntary and is intended for use in situations where a patient has a serious health condition in order to direct appropriate treatment by Emergency Services personnel.
Kate Gamble
Attorney at Law
Uptown Law PLLC
(360) 379-1818<tel:%28360%29%20379-1818>
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From: hhherman2 <hhherman2 at comcast.net<mailto:hhherman2 at comcast.net>>
Reply-To: WSBA Probate & Trust Listserv <wsbapt at lists.wsbarppt.com<mailto:wsbapt at lists.wsbarppt.com>>
Date: Friday, March 6, 2015 at 3:12 PM
To: 'WSBA Probate & Trust Listserv' <wsbapt at lists.wsbarppt.com<mailto:wsbapt at lists.wsbarppt.com>>
Subject: Re: [WSBAPT] Clients want to name children in Health Care Directive
My experience in talking to healthcare providers is that they want one person to have the authority to say yea or nay on pulling the plug rather than trying to get a consensus or majority among two or more persons. The worst case scenario is when it is up to two children who will not agree. But in any event, the plug will not get pulled without a “Do not Resuscitate Order” (green sheet) signed by a physician.
Howard Herman
Herman Herman & Jolley PS
509.220.5810<tel:509.220.5810>
From: wsbapt-bounces at lists.wsbarppt.com<mailto:wsbapt-bounces at lists.wsbarppt.com> [mailto:wsbapt-bounces at lists.wsbarppt.com] On Behalf Of Jennifer Y. Sohn
Sent: Friday, March 6, 2015 12:11 PM
To: 'WSBA Probate & Trust Listserv'
Subject: Re: [WSBAPT] Clients want to name children in Health Care Directive
Yes, I’m familiar with that culture, and I think their wishes can be respected by creative drafting.
From: wsbapt-bounces at lists.wsbarppt.com<mailto:wsbapt-bounces at lists.wsbarppt.com> [mailto:wsbapt-bounces at lists.wsbarppt.com] On Behalf Of Maureen Wickert
Sent: Friday, March 6, 2015 11:43 AM
To: WSBA Probate & Trust Listserv
Subject: Re: [WSBAPT] Clients want to name children in Health Care Directive
The authority for a HC AIF to direct the withdrawal or application of life sustaining treatment for someone should be cross referenced within a HCD and a DPOA for HC and these suggestions by others are very good. The client may have some strong cultural issues about involving their children in his or her health care. Another important issue is what if there are multiple children or co-AIFs for HC, what is the tie breaker for the doctor? If there is a single AIF for HC, this would simplify HC authority.
Very truly yours,
Maureen A. Wickert, Attorney at Law
WICKERT LAW OFFICE
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From: "Kate Gamble" <uptownlawpt at gmail.com<mailto:uptownlawpt at gmail.com>>
To: "WSBA Probate & Trust Listserv" <wsbapt at lists.wsbarppt.com<mailto:wsbapt at lists.wsbarppt.com>>
Sent: Friday, March 6, 2015 11:28:00 AM
Subject: Re: [WSBAPT] Clients want to name children in Health Care Directive
How about inserting language in the HealthCare POA giving the children authority to override the HCD in certain circumstances?
"It is my intent and desire that my attorney-in-fact honor any Health Care Directive or statement of similar nature and purpose which I have signed, but my attorney-in-fact shall have the authority to make the final decision regarding the withdrawal or application of life-sustaining treatment if at any time my attorney-in-fact determines that it would not be in my best interest to honor such Health Care Directive or statement of similar nature and purpose which I have signed.”
Kate Gamble
Attorney at Law
Uptown Law PLLC
(360) 379-1818<tel:%28360%29%20379-1818>
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From: "Jennifer Y. Sohn" <jennifer at sohn-law.com<mailto:jennifer at sohn-law.com>>
Reply-To: WSBA Probate & Trust Listserv <wsbapt at lists.wsbarppt.com<mailto:wsbapt at lists.wsbarppt.com>>
Date: Friday, March 6, 2015 at 11:16 AM
To: 'WSBA Probate & Trust Listserv' <wsbapt at lists.wsbarppt.com<mailto:wsbapt at lists.wsbarppt.com>>
Subject: Re: [WSBAPT] Clients want to name children in Health Care Directive
Why can’t the children be given the final say on whether to pull the plug or not if that is what the client wants?
From: wsbapt-bounces at lists.wsbarppt.com<mailto:wsbapt-bounces at lists.wsbarppt.com> [mailto:wsbapt-bounces at lists.wsbarppt.com] On Behalf Of LISA ATKINSON
Sent: Friday, March 6, 2015 10:48 AM
To: wsbapt at lists.wsbarppt.com<mailto:wsbapt at lists.wsbarppt.com>
Subject: [WSBAPT] Clients want to name children in Health Care Directive
Importance: High
Colleagues,
First time issue for me. Clients, non-native English speakers, want to put their children's names into a Health Care Directive to require physicians to consult with and get approval from the children before honoring the terms of the HCD. I have tried to explain, in many different ways, why this is not appropriate, but I can't find any legal citation to support my explanation.
Anyone have suggestions? I tried to suggest that under their Health Care POA, their children have a say in treatment/etc, but that the HCD is to be their choice.
Please let me know if you have suggestions.
Thanks,
Lisa
Lisa L. Atkinson, Esq.
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