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Living Wills, DNR Orders, and Other Confusing Terms

There is often a lot of confusion about various terms and documents relating to health care of a person who may be nearing the end of his life. Let's try to explain some things: PATIENT ADVOCATE DESIGNATION (PAD) also... 

called HEALTH CARE POWER OF ATTORNEY (HCPOA): This document is specifically authorized under Michigan law, and by this document you designate who is authorized to give or withhold consent to any medical tests or treatment in the event you are unable to make or communicate such decisions. It focuses on WHO will make the decisions, not on WHAT kind of care you want. (That is what a Living Will does.) A PAD or HCPOA will always include a HIPPA authorization (see below) for your Patient Advocate.HIPPA AUTHORIZATION: All of your medical information is private under federal law (the Health Information Patient Privacy Act, or HIPPA). No doctor, nurse, or other medical provider (not even an insurance company that is paying the bills) may disclose anything without your permission. Of course, if you are conscious and mentally competent you can always tell the doctors who they can or cannot talk to about your condition, prognosis, treatment, etc. But if you are not conscious and mentally competent, a HIPPA Authorization any medical provider to freely disclose your private medical information to the person named in the Authorization.LIVING WILL: This is a document to explain to your doctors and family what kind of treatment you do or do not want in the event you are not able to make your own decisions. There is no law in Michigan that recognizes such a document, but a Living Will does explain what your wishes are, especially regarding life support or other end-of-life treatment. Preparing a Living Will is a help to your family, or whoever you have designated to make such a decision.DO NOT RESUSCITATE (or DNR) Order: This is an order, signed by your doctor at your request, that tells your family and any medical provider that if your heart stops or you stop breathing, they should not call an ambulance or initiate any efforts to save your life. Think carefully before asking for a DNR order. A DNR means that you do not want the doctors or family to even consider whether or not you might recover from any such incident. It means that if your heart stops, or you stop breathing, they will not call an ambulance. This does not give room for your family to think through whether you might recover, or how satisfying your life might be if you were resuscitated. DNR orders should be used only when the chance of a meaningful life after resuscitation is not a realistic possibility.DURABLE GENERAL POWER OF ATTORNEY: This is for legal and financial matters, not for medical issues. This authorizes a certain person to act on your behalf in legal matters, such as accessing your bank account, withdrawing money from your IRA, authorizing your employer to start your pension, signing your tax return, selling your house, or any other legal matter. It can be broad and all-encompassing (a GeneralPOA), or it can be restricted to certain matters (a Limited POA). It is common, for instance, for people to sign a Limited Power of Attorney authorizing a spouse or a trusted friend to sign the documents selling or buying a house, when you might be out of town at the time of the closing.These documents may be part of a complete estate plan, a plan which will allow your family or other persons to act on your behalf in the event of an emergency. To learn which of these tools may be right for you and your situation, and to learn what else you can do to prepare for life's emergencies, consult with one of the estate planning attorneys at Creighton McLean & Shea PLC. 

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