By: Rudman Winchell Attorney Jonathan P. Hunter

Maine law permits competent adults and emancipated minors to prepare an advance health-care directive. An advance directive authorizes an agent to make health-care decisions for you if you become incapacitated. Your advance directive may also include specific instructions regarding provision or withdrawal of life-sustaining treatment, artificial nutrition and hydration, and treatment for pain.

Recent medical studies, however, have called into question the practical effectiveness of advance directives. In a disturbing number of the cases studied, advance directives were not known, not available, or not consulted by health-care providers.

Thankfully, there are steps you can take to help ensure that your advance directive is effective. First and foremost, you should discuss your advance directive with your agent, family members, and other loved ones, and consider providing them with copies. You should also provide a copy of your advance directive to your physician to be included in your medical file, and to any hospitals or other facilities at which you are likely to receive care. Discussing and circulating your advance directive helps ensure that the existence and contents of your advance directive are known.

Second, do not assume that your agent knows your wishes. Keep in mind that your agent will have to make decisions under difficult circumstances that you and your agent may not have foreseen. Discussing your health-care choices can be a difficult process for both you and your agent, but avoiding that discussion ultimately makes it more difficult for your agent to make decisions that best comport with your wishes.

Third, update your advance directive often. Things happen. Circumstances change. People change their minds. Make sure that your advance directive continues to reflect your wishes. The American Bar Association recommends that you revisit your directive whenever one of the “Five D’s” occurs:

  •          Decade – you start a new decade of your life.
  •          Death – you experience the death of a loved one.
  •          Divorce – you undergo a divorce or other major family change.
  •          Diagnosis – you are diagnosed with a serious health condition.
  •          Decline – you experience a significant decline in your health.

Advance directives are extremely useful tools for patients to delegate important health-care decisions to those that they trust. Executing the document itself, however, is only the first step. An advance directive is of little value if it is not known, is not in your medical file, is not understood by your agent, or does not continue to reflect your wishes. By following the steps discussed above, you can give your directive the best possible chance of success.

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