Health Care Proxy

On Friday we'll be meeting with a lawyer to finalize some documents including wills and healthcare proxies. I guess the way our lives had been going we would have gotten around to writing wills by the time we were fifty or sixty years old - you know, when it might be important to start thinking about that type of document.

Anyway, probably the more significant document we'll be preparing is the "Health Care Proxy". In the past an individual could create a document called a "Living Will" which would detail the types of health care they would desire if they were unable to communicate. For instance, the Living Will might state that "if I am unconscious then I don't want to be kept alive by a mechanical respirator". This document can give you peace of mind knowing that you were able to document your wishes ahead of time but it can also lack flexibility. Say you were in a nasty car accident which rendered you unconscious. The treating doctor might feel that you could be saved and rehabilitated, but it would require putting you on a mechanical respirator for one week. It appears the doctor may not be permitted that option if your "Living Will" prohibits that type of care.

Well, along comes the "Health Care Proxy". At least within New York state you don't need a lawyer to fill it out, just a few witnesses (see "NY health care proxy" listed under "Links"). Essentially the proxy states that you authorize a specific person to be able to make your healthcare decisions for you, in the event that you are unable to communicate. You can give the "proxy person" full authority, or you can limit their authority to only certain types of decisions. The proxy concept relies on the idea that you have discussed all the possible issues of importance with your proxy person. The types of decisions they can then make (with your pre-approval) are: whether mechanical means can be used to sustain your life, whether food and water can be provided thru IVs or feeding tubes to sustain your life, whether CPR can be administered if your heart stops, etc.

The proxy concept differs from the living will in that the appointed proxy can adjust decisions based upon your unique circumstances. In the example of the car accident, the proxy person has the flexibility to consider something like "I understood the patient didn’t want to kept alive by a mechanical respirator for years and years, but I know he would have accepted being on a mechanical ventilator for one week if it meant a likely full recovery". Basically the proxy person has the opportunity and flexibility to think and make the decisions which they believe you would have desired.

On Wednesday night we discussed Robin's view of what treatments she would want, and which treatments she would not want, in preparation for me to become her healthcare proxy, and for my Dad to be an alternate proxy if I'm not available.