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Why a Medical Directive is Smart

End-of-Life Decisions Aren’t Easy

Ever since the Terri Schiavo right-to-die case, which spanned from 1990 to 2005, people have realized what can happen if you do not have an advance medical directive in place. As many of us recall, at the young age of twenty-seven, Terri suffered a massive heart attack. She was resuscitated, but had severe brain damage due to lack of oxygen to her brain and was left comatose. Unfortunately, because Terri did not have an advance medical directive in place, and Terri’s family and her husband of six years did not agree on an end-of-life plan, the case was left to the courts, ultimately involved both state and federal politicians, including President George W. Bush. Had Terri prepared a medical advance directive, her wishes would have been upheld and years of legal challenges could have been avoided. 

One of the most important documents every person over the age of eighteen should have is a medical advance directive. This is the document in which you set out your wishes for how your health care is to be handled if you become incapacitated and are unable to make decisions for yourself.

Under Virginia law, you have the right to make all medical decisions for yourself as long as you are competent. If your doctor says you need a procedure, you have a right to decide for yourself whether you will go forward with the recommended care.

But what if you are in a terrible accident, or have an unexpected stroke or heart attack, which renders you mentally or physically unable to make a decision about your healthcare? Isn’t this something that you would want to have a role in deciding? You can state your wishes in an advance medical directive and name an agent to carry them out.

Because this matters so much to people, the legislature has enacted statutes that allow an individual to make an advance medical directive. You can think ahead of time about how you would want various matters to be handled and can address this in a properly crafted legal document. This includes deciding who will make health care decisions for you when you can’t do it yourself; what kind of medical treatment you want or don’t want if you become seriously ill, are in a coma, or have severe brain damage and are not expected to recover; or if you are close to death, and treatment would only delay the moment of death.

You can create an advance medical directive without an attorney, but many people prefer to have an attorney guide them through the decision-making process and create a document tailored to them. An attorney can help you examine what terms you want, who to select as your agent(s) and back up agent(s), and what factors to consider. It is particularly important to select someone you can trust to follow your wishes as determined, and someone who will be a strong advocate for you with your family and doctors.

The attorney can also talk over with you what you will want to discuss with the person you name as agent, who you will give copies of the document to, and whether you want to place the document on an online registry with the Virginia Department of Health. While none of us wants to think that it will ever happen to us, the Terri Schiavo case is a perfect example of how important it is to have your legal affairs in order.

Phoebe Hall
Phoebe P. Hall is an elder law, estate planning, and family law attorney who has been practicing law since 1969. She is CEO of Hall & Hall, PLC and sits on the board of visitors for Virginia Commonwealth University. A Richmond resident, she has two children and three granddaughters.
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