Springfield Business Journal Articles


Who Will Make Your Medical Decisions?

Unfortunately, many of us have watched a loved one suffer with a debilitating disease, an injury or the effects of aging. Many of us have had to make difficult decisions regarding treatment and even life support. Unlike Terri Schiavo's situation, most people make these heartbreaking decisions in private. The primary reason Ms. Schiavo's case is being played out in the courts is that she did not document her wishes. Most 26 year olds (the age she was when she became ill) have not. Have you thought about what will happen if you are the one with the illness? What treatment would you want? Would you want life support to be terminated? How do you enforce your wishes?

First and foremost, you are the only person authorized to make medical decisions if you are able. If you are not able to do so, for example, if you have had a stroke, someone else will need to make the decisions for you.

You should make your wishes regarding medical treatment known to your family and your doctors and other medical providers. Illinois law provides for several documents that you can use to express our wishes.

The first document is a "living will." A living will governs "death delaying procedures." It provides that if you are suffering from an "incurable and irreversible injury, disease, or illness, judged to be a terminal condition by your attending physician who has personally examined you and has determined that your death is imminent except for death delaying procedures," that your physician is to withhold or withdraw the death delaying procedures and to administer treatment only as necessary to provide comfort to you. However, the Illinois living will statute provides that food and water cannot be removed if doing so will be the cause of death. Therefore, you could not die of starvation as Terri Schiavo will. If, for example, you were on a respirator and a feeding tube and you would die quickly if the respirator were removed, then both machines could be removed because you would not die from the removal of the feeding tube.

The second document is a health care power of attorney. Although the health care power of attorney can address the termination of life support, it is actually much broader in scope. An agent under a health care power of attorney can authorize medication, surgery, and even organ donation. Under the statutory form, you can designate only one person to serve as your agent at a time. For example, you cannot name two of your children to serve jointly. You can, however, name an alternate agent or agents.

A third document is a do not resuscitate order ("DNR"). A DNR order directs medical care providers not to start cardiopulmonary resuscitation (CPR) if your heart or breathing stops. A DNR must be executed by your doctor and is prepared only after you have become ill. Unlike the living will and health care power of attorney, it is not prepared by healthy people in advance.

All of these forms can be found online at the Department of Public Health's web site at http://www.idph.state.il.us/public/books/advin.htm. If you choose to prepare your own documents, you must follow all instructions carefully. For example, each document requires witnesses, and the witnesses cannot be related to you.

If you have not executed any of these documents, the law still provides for a surrogate decision maker for you. Your family may ask a court to appoint guardian for you. If a guardian of the person is appointed, he or she will have the authority to make medical decisions for you.

If a guardian is not appointed, the law provides that certain people have priority in making your medical decisions. They are: (1) the patient's spouse; (2) any adult son or daughter of the patient; (3) either parent of the patient; (4) any adult brother or sister of the patient; (5) any adult grandchild of the patient; (6) a close friend of the patient; (7) the patient's guardian of the estate. Of course, if there are several people in any category, such as adult children, there can be disagreement, which is why you may choose to execute a health care power of attorney.

No matter what your wishes are regarding medical treatment, life support, organ donation, etc., the most important thing you can do is discuss your wishes with your family. The decision to terminate life support is extremely difficult, and your loved ones will be comforted by knowing that they are complying with your wishes. Likewise, if organ donation is important to you, tell them so that they can donate your organs with confidence that it was what you wanted. Finally, if you have a living will, power of attorney, etc., give copies to the persons you name as well as your doctor. No one can use the documents if they do not know that they exist or where they are.

by Sarah Delano Pavlik
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