In November of 2017, a man was brought unconscious into a Florida Hospital emergency department. When the staff opened his shirt, they discovered a “Do Not Resuscitate” tattoo across his chest. The word “not” was underlined and a signature was beneath the words.
Now, given the extraordinary lengths this gentleman undertook to make his healthcare wishes known, did the hospital attempt to perform life-saving measures on the man?
Yes, because, as illustrated in a case study about the event, “this patient’s tattooed DNR (do not resuscitate) request produced more confusion than clarity, given concerns about its legality and likely unfounded beliefs that tattoos might represent permanent reminders of regretted decisions made while the person was intoxicated.”
Once the hospital’s ethics committee became involved they advised honoring the DNR tattoo. “They suggested that it was most reasonable to infer that the tattoo expressed an authentic preference.”
However, the case study clarifies how important it is, for people who have specific wishes for their medical care, to get those requirements down in writing on a legal document. This patient literally had his healthcare preferences tattooed on his chest – and they still weren’t immediately followed.
“Estate planning documents are the kind of thing that everybody keeps planning to get around to and, still, two-thirds of Americans have no written estate plan in place,” said Catherine Hammond, attorney at the Hammond Law Group, which practices only estate planning and elder law.
If you do not have these documents prepared, or haven’t had them reviewed in a few years, it is time to make some estate planning resolutions.
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Resolution #1: A Will or Revocable Living Trust
One of the first documents to get in place is either a will or a revocable living trust.
A will is a legal document that clearly states how you would like your assets distributed after you die, as well as who will care for minor children. To ensure that your wishes are followed, it’s best that your will is prepared by an attorney, is signed by you and the necessary amount of witnesses, and clearly appoints a legal representative to carry out your requests.
A revocable living trust is a legal entity that is created to hold your assets. Unlike a will, which only goes into effect after you die, a trust is effective as soon as it is created. This type of trust can be amended (hence the term “revocable”) and can be used in place of a will.
A big difference between a will and a trust is that a will passes through probate if you own a home or other substantial assets, while a trust avoids the probate process. Because of this, a trust can save your heirs time and money.
Resolution #2: Advanced Medical Directives
Advanced medical directives are legal documents that clearly state your wishes should you become medically incapacitated and unable to communicate your wishes.
Healthcare Power of Attorney
This document authorizes a person of your choosing to make medical decisions if you’re not able to communicate your wishes. These decisions might include the type of treatment, whether or not to perform surgery, admission to a long-term care facility, or end-of-life decisions.
This is a legal document that is very clear about the medical treatments you would and would not want in a limited set of circumstances. A living will usually covers such topics as the lengths hospital staff should go through to keep you alive, pain management, and organ donation.
Do Not Resuscitate Orders
This document indicates specifically that you do not want life-saving actions taken should your heart stop beating, such as cardiopulmonary resuscitation (CPR), tracheal intubation, and being put on a breathing machine. As the opening story illustrates, it is best to have these wishes documented on paper and not across your chest.
Resolution #3: Financial Power of Attorney
A financial power of attorney gives someone you select the legal power to act in your place should you become mentally incapacitated. For a financial power of attorney, you authorize a trusted person to handle financial transactions on your behalf, such as banking, real estate, and investment transactions. There are a variety of types of financial powers of attorney, so it’s important to understand the fine print on the document you sign.
Resolution #4: A Universal HIPAA Release
This form is extremely important – and it’s also the one that most people overlook.
Once someone turns 18 and legally becomes an adult, they fall under the Health Insurance Portability and Accountability Act (HIPAA), which protects the confidentially of their medical information.
The act prohibits healthcare providers from releasing healthcare information to anyone other than the patient. This means if an 18-year-old is in a car accident and unresponsive, doctors cannot tell his or her parents any healthcare information without approval. Mom and Dad can call the hospital, and the hospital may refuse to confirm or deny whether their child is even in the hospital.
A universal HIPAA release gives the necessary approval. Everyone listed on the form is able to know about someone’s health status, which can save a lot of heartache in a time of crisis.
Resolution #5: Update Your Current Documents
Even people who have an estate plan in place need to dust off those documents and make certain that they are still relevant to their current lifestyle.
There are a number of reasons that could lead to estate-planning documents needing to be updated, including:
- Having a new child
- Changing jobs that resulted in new retirement savings
- Receiving an inheritance
- Having less money than expected, for example , due to a costly medical issue
- Changes in the lives of your children, like a child becoming an adult or getting married
“A lot of people think that if they don’t have their child’s spouse named in their estate plan the spouse won’t receive part of the inheritance, but that’s a myth,” said Hammond. “If your child is married when you die, typically their spouse ends up with 50 percent of their inheritance. Fortunately, if you have concerns about that spouse, there are things you can do with your estate plan today to prevent that from happening.”