Exploring The Various Types Of Advance Directives
An advance directive can play an important role in any effective estate plan. Advance directives can accomplish goals that no other estate planning tools are capable of achieving, and there are many different types of advance directive that may apply, depending on an individual's circumstances and concerns. Estate planners in Texas can schedule a consultation with Jason English Law to review their options and develop a suite of estate planning documents, including advance directives, to meet their unique needs.
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What Is an Advance Directive?
An advance directive is a legal document that consists of written instructions provided by an individual in anticipation of such time as they may be unable to give such instructions in real time on their own behalf. For the most part these instructions express the preferences of a patient when it comes to medical care and end-of-life decisions. In almost all situations, medical professionals are legally required to adhere to these instructions if the patient can no longer express their own preferences in a normal manner. As the National Institute on Aging explains, an advance directive goes into effect only when the principal becomes incapacitated.
Reasons for Advance Directives
There are a few different types of advance directive. A single individual may have more than one type of advance directives, but it is important to keep advance directives up to date to ensure that all documents are consistent and reflect the current preferences of the individual whose interests they are intended to serve. Individuals in all walks of life may choose to prepare advance directives to fulfill a variety of purposes, as outlined below.
Seniors Who Wish To Pass Away on Their Own Terms
Many seniors grow tired of medical treatment and wish to pass away on their own terms. They may be dealing with chronic pain, mobility issues, and a general sense of fatigue. They might have experienced long stays in hospitals, and they may decide that they do not wish to repeat this process. As a result, seniors can create advance directives that limit future treatment and allow them to pass in a somewhat natural way with little to no medical intervention.
Individuals Who Prefer Not To Live With Disabilities
Some individuals may believe that certain disabilities and medical issues would negate their enjoyment of life. Commonly cited conditions include, but are not limited to, paralysis, severe brain damage, amputations, severe burns, vegetative states, or the loss of bodily organs. Even though it might be possible to keep patients alive with these medical issues, the patient may decide ahead of time that they would rather refuse such treatments.
People Who Wish To Refuse Certain Treatments on Religious Grounds
Many religions prohibit certain medical treatments. If religious patients lose the ability to communicate, there is a chance that their religious needs may not be met as doctors attempt to provide treatment. Religious individuals can create advance directives that ensure certain treatments are always withheld on religious grounds. Some religious individuals in Texas object to treatments involving stem cells, and so these individuals may wish to include language in their advance directives indicating their refusal of treatments involving stem cells.
In some situations, doctors and institutions can potentially refuse to honor advance directives based on religious views if the directives are not medically appropriate. Speak with Jason English Law to learn more about which religious advance directives may be considered medically appropriate.
The Difference Between Suicide and Refusing Treatment
While physician-assisted suicide is illegal in Texas, patients can create advance directives that ensure the withdrawal of “life-sustaining treatments.” One common scenario is the choice not to be resuscitated in the event of a heart attack or stroke. They may also pre-emptively refuse nutrition and hydration given intravenously or by stomach tube. Similarly, a patient's advance directive can establish ahead of time their desire to be taken off life support after a catastrophic accident.
Different Types of Advance Directive
In Texas, the various types of advance directive are overseen by the Department of State Health Services. This government agency has outlined a number of distinct categories.
Declaration for Mental Health Treatment
Also known as a “DMHT,” a declaration for mental health treatment covers psychoactive medication, convulsive therapy, and emergency mental health treatment. With this document, patients can give or withhold consent for these treatments even if they are incapacitated.
Directive to Physicians and Family or Surrogates
This type of advance directive allows patients to outline their preferences in regard to a wide range of potential treatments. Directives of this type are addressed to anyone who might be placed in a position of decision-making authority over the medical treatments provided to a patient. The Department of Health and Human Services in Texas provides patients with a form that covers terminal conditions, life-sustaining treatment, and a space for additional requests. The form also contains an option to instruct doctors to let the patient die “as gently as possible.”
Medical Power of Attorney
Also known as a “MPOA,” this document allows patients to give decision-making authority to someone else if they ever become incapacitated. Patients often name spouses as their “agents” in the context of healthcare decisions, but unmarried partners, adult children, and friends of long standing are also common choices.
Out-of-Hospital Do-Not-Resuscitate Order
Also known as an “OOH-DNR,” an out-of-hospital do-not-resuscitate order instructs emergency medical personnel and healthcare professionals to forgo resuscitation attempts. The goal is to allow the patient to pass away on their own terms.
Statutory Durable Power of Attorney
Also known as a SDPA, a statutory durable power of attorney allows patients to select an agent who will have the authority to make decisions regarding their property if they become incapacitated. Unlike the other types of advance directives listed above, a SPDA does not apply to any medical decisions.
Who Needs an Advance Directive?
According to Texas Health and Human Services, everyone should consider an advance directive. Virtually anyone may eventually encounter a situation where they can no longer express their medical preferences or manage their own affairs through normal interactions. This may affect young, elderly, healthy, and disabled people alike.
That being said, Health and Human Services does explain that there are a few situations that may make the creation of an advance directive especially important for the individuals affected by them. Some groups for whom creating an advance directive may be a particular priority include:
- Those with Alzheimer's disease
- Those with mental health issues
- Non-verbal individuals
- Those who do not wish to be resuscitated
- Those with chronic illnesses
- Those who regularly engage in high-risk activities
Advance Directives Can Make Life Easier for Family Members
Advance directives may benefit entire families, not just the patients who write them. By creating an advance directive, a patient can save their family members from making difficult decisions. With important end-of-life and life-sustaining treatment questions already answered, family members may feel a sense of peace knowing that the preferences of their loved ones are being respected.
Reach Out to a Texas Estate Planning Attorney Today
Each patient has slightly different priorities and needs, and it makes sense to review the various types of advance directive with the advice and assistance of an estate planning attorney. Developing a greater understanding of the available options and how they may be used together makes it easier to select the right estate planning tools to address your concerns and serve your individual needs. Creating an advance directive alongside an estate planning lawyer may also help to ensure that the finished documents are valid and enforceable.