legislation allowing a power of attorney to be "durable," that is, enduring even if the
maker's competency doesn't last. To create a Durable Power of Attorney for Health
Care, the instrument must merely state that it is intended to be durable, or that the
power created will not be affected by the incapacity of the maker. Durable-power-of-
attorney laws vary by state, with some states allowing Durable Power of Attorneys for
Health Care to cover health care decisions. (The person designated as primary and
backup should, of course, have a full understanding of the patient's desires.) Some
states with DPAHC laws may allow agents to be named to make medical treatment
decisions, to include withdrawal of life-sustaining treatment. Other states do not include
decisions for withdrawal of treatment. Still other states have durable-power-of-attorney
laws that do not address medical treatment decisions at all.
c. Durable Power of Attorney for Health Care. Since there is only one state
court decision in this area (from New Jersey), there is an insufficient basis for
anticipating how the courts will interpret the use of a Durable Power of Attorney for
Health Care. For example, it is not known whether or not the "Do Not Resuscitate
(DNR)" decision made by the holder of a power of attorney for an incapacitated patient
would be upheld, especially if there were no other indication of what the patient would
have wanted. In principle, a Durable Power of Attorney for Health Care would be
effective in a military treatment facility (MTF) under the reasoning expressed, above, for
living wills. In any case, a DPAHC (where applicable) may increase the likelihood that
one's living will be honored.
d. Preparing Advance Directives that Carry Clout. To ensure that the living
will is as effective as possible, you should. 1) specify applicable conditions and
treatments, 2) renew the document at least every 2 years, and 3) in the states where
applicable, have a DPAHC drawn up, as well.
(1) Be specific. The living will should be as specific as possible in citing the
conditions for which the patient does not wish heroic treatment and the types of
interventions not desired, for example, respirator, feeding tube, and so forth.
(2) Renew every two years. The document would be renewed every two
years. Physicians are apt to disregard a living will if it is several years old, or if it fails to
specify the particular condition that you happen to develop.
(3) Have a Durable Power of Attorney for Health Care if applicable. Having
a DPAHC, if applicable in your state, increases the likelihood of compliance with your
living will.
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