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Legal TopicsYou may believe that your living will is sufficient for all of your health care planning needs. However, a living will addresses only the withdrawal of life support. It does not address treatment, medication, and residential placement. The durable power of attorney for health care is a more comprehensive planning method for health care contingencies. Following is a brief explanation of these advance directives. Living Will A living will is a document that is signed, dated, and witnessed in compliance with the Illinois Living Will Act. When properly executed, a living will enables you to dictate directly, not through an agent or surrogate, your desires with respect to the use of life-sustaining procedures during a terminal illness. A living will generally contains a provision that permits a person to die naturally under the following circumstances: (1) the person has an incurable and irreversible injury or illness that is determined by the attending physician to be a terminal condition; and (2) death is imminent without the implementation of death-delaying procedures. The Illinois Living Will Act states that food and water shall not be withdrawn or withheld if doing so would result in death solely from dehydration or starvation rather than from the existing terminal condition. Despite judicial interpretation of the statute, the precise circumstances under which a feeding tube can be withdrawn remain unclear. Consequently, health care providers proceed conservatively and many refuse to terminate tube feeding, citing the statutory prohibition. Because the living will has a very narrow purpose and application, it is not the instrument of choice for most people. However, if you fall into one of the following categories, the living will can be an appropriate advance directive: 1. Persons in the final stage of a terminal illness for whom death-delaying procedures may soon he necessary; 2. Persons who wish to relieve family members of the burden of terminating tinting life-sustaining treatment; or 3. Persons who cannot decide whom to name as their agent under their durable power of attorney. Durable Power of Attorney for Health Care A "durable" power of attorney is one that is effective until your (the principal's) death unless you revoke or amend it. A durable power of attorney for health care permits you to delegate health care decisions to a trusted person (your agent) in the event that you become incapacitated and unable to make your own health care decisions. The Durable Power of Attorney Act sets forth a statutory short form power of attorney for health care, but nonstatutory forms may also be drafted. The statutory short form requires the signatures of the principal and one witness. The durable power of attorney for health care can do everything a living will can do and much more. For example, the agent may be given broad authority to order the withholding of death-delaying procedures, including tube feeding and hydration, without regard for statutory prohibitions under the Illinois Living Will Act. Your agent can also be given authority to make other health care decisions for you, including admission to or discharge from a hospital or long-term care facility, medical consent, and anatomical gifts. Agents may also be specifically forbidden from making certain decisions on your behalf. With our counsel you can tailor the durable power of attorney to your wishes. A durable power of attorney for health care becomes effective upon execution unless otherwise specified in the document. You can make the power of attorney effective at a future date or upon the happening of a certain event (such as a medical disability). The durable power of attorney for health care may be revoked or amended at any time regardless of the mental or physical condition of the principal, but only by using one of the methods described in the statute. Failure to Execute an Advance Directive If no advance directive is executed, the Illinois Health Care Surrogate Act allows an attending physician to recognize a surrogate for those patients who lack competence or decisional capacity. The surrogate is empowered to make decisions about life-sustaining treatment on the patient's behalf. While the Illinois Health Care Surrogate Act offers families an alternative to a court proceeding, execution of a living will or durable power of attorney will provide you with more control and flexibility in making decisions about your medical treatment. To spare your loved ones the uncertainty and anguish of a statutory surrogacy, contact us for counseling about the use of a living will or durable power of attorney for health care.
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