Medical Decision Making: The Role of Living Wills and Healthcare Powers of Attorney
Introduction to Legal Principles
What if a person does not have the capacity to make his own difficult end of life medical decisions?
If you can’t make decisions for yourself at the end of your life, doctors, courts, or others might do things that you wouldn’t want. To prevent this, you can create a living will. A living will helps you clearly state what kind of medical care you want or don’t want if you’re nearing the end of your life and can’t communicate. It also lets you choose someone to make decisions for you if you can’t make them yourself. This way, your wishes about life-sustaining treatments and other end-of-life care are respected even when you can’t communicate them.
When discussing legal documents related to healthcare, two important tools are often considered: living wills and healthcare power of attorney. Both are used to guide medical decisions when an individual cannot communicate their wishes. However, they serve distinct purposes and are structured differently.
You can combine a living will and a healthcare power of attorney into one document, often referred to as an advance directive. This single document allows you to both specify your medical treatment preferences for end-of-life care and appoint someone you trust to make healthcare decisions on your behalf when you cannot communicate. By consolidating these documents, you ensure that your wishes are clearly outlined and that your chosen agent can make decisions that align with your values and preferences. This approach simplifies the process for healthcare providers and your family, ensuring that your medical care aligns with your desires.
What is a Living Will?
A living will, also known as an advance directive, is a document that outlines an individual’s preferences for medical treatment when they are unable to communicate. It typically includes directives for withholding life-sustaining treatments in cases where there is no hope of recovery and can also cover organ donation and other personal wishes.
Importance and benefits of a Living Will
Creating a living will is crucial as it significantly reduces the emotional burden on family members during a medical crisis. By clearly stating your wishes regarding life-prolonging measures, it prevents family conflicts over whether to continue or withdraw life support. A living will is especially important if you lack the capacity to make medical decisions, providing written evidence of your wishes and ensuring your quality of life preferences are respected. It offers several benefits, including reducing family trauma by avoiding disputes over medical decisions, clarifying which life-sustaining treatments you do or do not want, and allowing you to express your wishes regarding organ donation.
Validity Requirements for a Living Will
For a living will to be considered valid, several key requirements must be met. First, the person creating the living will must be at least 18 years old. They must also have the mental capacity to understand the decisions they are making. Additionally, they must be fully informed about their medical condition and proposed treatments before refusing any interventions. Lastly, the treating doctor should confirm that the individual has not changed their mind after signing the document.
Formal Requirements for a Living Will
While there is no specific format required for a living will in South Africa, it is recommended to include certain details to ensure clarity and effectiveness. The document should include the individual’s full name and address as they appear on their identity document. It should also clearly list the medical treatments the person does or does not consent to. Finally, the document must be signed by the individual and witnessed by two competent individuals who are not family members or medical practitioners.
What is a Healthcare Power of Attorney?
A healthcare power of attorney (also known as a medical power of attorney) is a document that appoints a trusted person, known as an agent or proxy, to make healthcare decisions on your behalf when you are unable to do so. This agent can make decisions about treatments, surgeries, and other medical interventions based on your expressed wishes or their understanding of your values.
Legal Status of Living Wills in South Africa
Living wills are not formally recognized as legally enforceable documents in South African law. However, they are ethically accepted and can provide valuable guidance to medical practitioners and family members. The lack of specific legislation means that their enforceability remains uncertain, but they are increasingly seen as important tools for respecting patient autonomy and dignity.
Conclusion
Living wills and healthcare powers of attorney are essential tools for ensuring that your medical wishes are respected when you cannot communicate. While a living will provides specific instructions for medical treatment, a healthcare power of attorney appoints someone to make decisions on your behalf. Understanding the differences and benefits of these documents can help individuals maintain control over their healthcare decisions and reduce family trauma and conflict.