Will you have a living will when medical crisis strikes?  It seems as though life just plods along and nothing changes; but then, everything changes in a moment.

We’ve had clients who are seemingly healthy and all of a sudden are injured or seriously ill.  If you are so ill that you cannot give informed consent, you can’t sign a living will.  Like all estate planning documents, you need to have them in place before you actually need to use them.

Let us tell you about a woman named, Grace.  Grace and her husband had moved to a retirement community and they updated their estate planning documents after the move.  (Any time you move to a new state, it’s wise to have your documents professionally reviewed for updates.)

Grace included a living will in her estate plan.  She didn’t want to be kept alive with medical heroics (including life support machines) if she was in an irreversible coma or persistent vegetative state.

She was diagnosed with cancer shortly after her move and gradually went down hill.  One day, she fell, calling out her husband’s name.  Grace never regained consciousness.

The doctors examined her and determined that she was brain dead; they asked if she had a living will.  She did.  Her husband brought it to the hospital.  He and their children visited and then life support was removed.

Grace died peacefully just 15 minutes later.  While her family was sad to lose her, they felt at peace with the execution of the living will.

Duffy Law Office is a member of the American Academy of Estate Planning Attorneys.

You have sought effective legal advice and created a valid and legally binding living will with the assistance of your attorney. Your living will contains instructions to your attending physician that in case you become terminally ill, your wishes are to decline life-sustaining medical procedures.

In Iowa, a life-sustaining medical procedure is one that requires medical intervention to prolong the process of dying while terminally ill or to restore your necessary bodily functions or vital signs. Without medical intervention, you will surely die. Examples of life-sustaining procedures include medically resuscitating equipment that uses artificial or mechanical means to restore your vital functions. In 1992, the Iowa legislature included feeding tubes designed to provide your body with necessary nutrition and hydration to keep you alive. 10 years later, the Iowa legislature what procedures are defined as resuscitation procedures. These include using any medical means to sustain, restore, or supply your vital functions. They include defibrillation, emergency chest compressions and intubation to deliver hydration and nutrition. The legislature also included cardiac restoration drugs intended to resuscitate you during cardiac arrest.

However, the term “life-sustaining” does not include medical procedures that are not delivered to resuscitate your vital signs but merely delivered to alleviate your pain or provide you with comfort during a physically painful condition.

If you do not have a living will or advance directive, then under Iowa law, your doctor can make medical decisions before at least one other witness, in participation with certain individuals. The individuals who can participate in decisions regarding medical treatment during a terminal illness include an individual with a power of attorney to make healthcare decisions, a guardian appointed by court, your spouse, your adult children, your parents or adult siblings. Iowa law follows an order of precedence giving respective priority to these individuals. As such, you should understand the statutory order of precedence by contacting our office or another Iowa attorney specializing in this area of law.

Duffy Law Office is a member of the American Academy of Estate Planning Attorneys.

Not to be confused with a living trust, a living will is a written document that allows you to control medical decisions for your medical treatment if you are unable to make those decisions. Referred to as a “living will,” the document allows you to control your medical decisions if you are no longer capable of making those decisions due to mental or physical incapacity. Also known as an “advance directive,” federal law requires hospitals and nursing homes to notify you of your rights to execute a living will to help you during a terminal illness or disability.

Because of the legal complexities and seriousness of living will directives, you should seek advice from an Iowa attorney familiar with the Iowa laws regarding legally binding advance directives or living wills.

State laws govern the legal requirements to create a valid living will. You can create a living will in Iowa if you are at least 18 years old and mentally competent to create one. You must sign your living will or advance directive in front of a notary or two independent witnesses who are each at least 18 years old. If you can find two witnesses who are not family members, it is better to use those two independent witnesses. Your physician or other healthcare provider cannot serve as a witness. Your witnesses or notary must also sign your living will in your presence. You must be able to sign your living will voluntarily. This means that you cannot be under duress, under the influence or mentally incompetent. You must know that the document that you are creating and signing is your living will affecting your decisions regarding your future medical care.

Duffy Law Office is a member of the American Academy of Estate Planning Attorneys.

Many people choose to include healthcare directives in their estate plan in order to plan for their medical future.  Do you want to outline your wishes for medical treatments and procedures?  If you want to make sure that your wishes are followed, you need to include healthcare directives in your plan.  Look at the information below to learn more about the need for medical and health planning.

What medical procedures can I include?

Many medical procedures and treatments wishes can be discussed in your planning.  Some of these include the following:

• Artificially administered food and water
• Pain relieving medications
• Cardiopulmonary resuscitation
• Dialysis
• Diagnostic testing
• Blood products
• Medications
• Surgery

The above examples are some of the medical wishes that you can outline in your healthcare directives. It may be difficult to think about these topics, but taking some time to plan now could make a big difference in the future.
What can a healthcare power of attorney agent do?

A healthcare power of attorney agent can do a number of things.  Your agent will be responsible for making sure that the medical treatment that you receive follows your wishes.  Your agent will also make sure that you’re receiving proper care.  An agent can do the following:

• Hire and fire medical professionals
• Access all medical records and documents
• Visit you at the hospital or medical facility outside of visiting hours
• Obtain court order to stop treatment if it does not follow your wishes

It’s important that you discuss your medical wishes with your agent.  In some cases, your wishes may not be clear. You want to make sure that your agent will be able to help you make difficult medical decisions in the future.

If you have any questions about the need for healthcare directives, consult with a qualified estate planning attorney.

Duffy Law Office is a member of the American Academy of Estate Planning Attorneys.