Understanding Legal Terms Related to Medical Decisions
What is a power of attorney (POA)?
A “Power of Attorney” (POA) means that you have designated someone to act as your agent if you are incapable of making decisions for yourself. Usually, a written, legal document spells out the agent’s decision-making authority. Most general POAs give agents the power to make financial decisions and sign legal documents. In some states, like Virginia, you may also make medical decisions. In other states, you must use an advanced directive to make medical decisions or assign a healthcare decision-maker. As a caregiver, a durable power of attorney provides greater flexibility for what you need because it takes care of financial and medical decisions.
What is a Durable Power of Attorney?
Your authority as a general power of attorney stops if your family member becomes incapacitated or dies. In comparison, a durable POA continues to have authority regardless of mental or physical health status or death. Therefore, if you are a power of attorney for someone with a medical condition who becomes unconscious, you can decide for them if you are a durable POA but not a general POA. Virginia recognizes a general POA as a durable power of attorney for medical decisions.
Is a Medical Power of Attorney the Same as a Durable POA?
A Medical Power of Attorney makes decisions specific to health care issues and maybe the same person or someone different from the agent (person) who serves as the Durable POA. You can make your Durable POA document incorporate (include) medical decisions by merely referring to it in the same form. Medical decisions also appear in Advanced Directives.
What type of decisions does a Medical POA usually make?
A Medical POA usually has the following authority:
- consent to or refuse medical treatment to the same extent you could for yourself, with limited exceptions such as terminating a pregnancy, authorizing some psychiatric treatments, or going against any of your known wishes (unless you explicitly give your agent permission to override your previous instructions)
- see your medical records
- select or change your health care providers
- choose the facilities where you will receive treatment
- visit you at any time in any medical facility, or
- Go to court on your behalf if a doctor or medical facility refuses to honor your documented wishes for care or the authority of your health care agent.
What is a living will, and how is it different from an advanced directive?
A living will denotes what type of life-prolonging treatment you may or may not want if diagnosed with a terminal condition. However, an advanced directive covers more than just end-of-life events. An Advance Directive allows you to state your preference for any medical decision potentially needed in advance. Therefore, your wishes are known in advance if you cannot speak for yourself.
What is a “Do not resuscitate” (DNR) order?
A “Do Not Resuscitate” (DNR) order is a doctor’s order saying that the medical or emergency response system (EMS) will not take action to revive you if your heart or breathing stops. Instead, they will make you comfortable and honor your wish not to be resuscitated. The result of this non-action is that the patient begins the final stages of the dying process.
What is Hospice Care?
Hospice care focuses on providing compassionate care to people in the last phases of incurable disease so they may live as fully and comfortably as possible. The hospice philosophy is to accept death as the final stage of life. Therefore, hospice does not hasten death or postpone death but treats the person and symptoms of the disease rather than treating the disease itself. Hospice care is also family-centered, including both the patient and family in making decisions.
How is Palliative Care Different from Hospice?
Palliative care is care given to improve patients’ quality of life who have a serious or life-threatening disease. It addresses the whole person, not just the condition, and involves a comprehensive approach to managing the individual’s well-being. Treatment addresses the individual’s psychological, social, and spiritual issues in determining the best approach to comfort care, supportive care, and symptom management.
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