Wednesday, December 02, 2009

Health Care in Your Control

As the debate over Health Care reform continues in Congress, it is a good time to focus upon those Health Care issues over which you have control.  First, you want to think about how to express your wishes should you lack the capacity to make decisions for yourself due to a medical emergency.  If you had an incurable or irreversible condition that would likely result in your death within a short period of time, would you want artificial nutrition and hydration removed?  Do you want treatment for the alleviation of pain even if it may hasten your death?  Would you prefer to be at home if possible?  Would certain music or other ambience make you more comfortable?

Once you have identified your wishes, whom would you trust to ensure that your wishes are carried out?    Will those persons be able to act under pressure?  Will those persons be available during an emergency?  It is a good idea to have a candid conversation with your possible Health Care agents about your wishes to see if they share your same philosophy with regard to Health Care issues.  If they do not share your same philosophy, you need to explore whether they would nevertheless be able to carry out your wishes. 

After you have identified your Health Care wishes and those whom you trust to carry out such wishes, it is a good idea to memorialize those wishes in an Advance Health Care Directive.  In addition, you will want to make sure that your loved ones and your Health Care agents will be able to access your health information in the event of an emergency in order to make informed decisions with regard to your Health Care.  As a result, be sure to execute a document authorizing the disclosure of health information to specified individuals, often referred to as a “HIPAA Waiver” (named after the state and federal medical privacy laws).

Executing an Advance Health Care Directive and a HIPAA Waiver, however, will not inform your health care providers (1) that you have such documents and (2) how to obtain such documents in an emergency.  This could be a major problem, especially if you become ill or injured while you are traveling out of town, out of state, or even out of the country.  I often advise my clients to take advantage of programs such as Docubank, a company that stores your health care documents in an electronic database and gives you a card to put in your wallet with instructions to emergency care providers on how to obtain copies of such documents 24 hours a day, 7 days a week.   

A qualified Estate Planning attorney can help you ensure that your Health Care wishes will be carried out in the event of your incapacity by helping you identify your wishes, helping you articulate your wishes in legally binding documents, and providing a mechanism to inform your health care providers about your wishes.