Advance healthcare directives are legal documents that outline an individual’s medical care preferences in case they cannot communicate them. These directives ensure that healthcare providers and loved ones follow your wishes, even when you can’t speak for yourself. This is an eventuality you must plan for, as underlined in the tragic story of Nancy Cruzan.
Why They Matter
Nancy Cruzan was a young woman whose life took a tragic turn after a car accident near Carthage, Missouri left her in a persistent vegetative state. She could not communicate or make decisions. However, her body was kept alive through a feeding tube. Her parents, believing that Nancy would not want to live in such a condition, fought to have her feeding tube removed. However, they faced legal battles because there were no written instructions from Nancy about her wishes.
In 1990, Nancy’s case reached the U.S. Supreme Court, which ruled that without clear, written evidence of her wishes, the state had the right to continue life-sustaining treatment. Not until a lower Missouri probate court reheard evidence from new witnesses did a judge grant permission for the hospital to remove the feeding tubes keeping Nancy alive. She passed away 11 days later.
This heartbreaking situation emphasized the importance of having advance healthcare directives in place. Without hard evidence, it’s impossible to determine what Nancy would have preferred. However, if she had formalized her wishes in writing, either preference would have spared her family’s legal struggle and preserved some of her autonomy.
Who Should have Advance Healthcare Directives?
Many people assume that advance directives are only necessary for the elderly or those with terminal illnesses. However, the National Institute on Aging makes the case that everyone should create these documents.
Accidents and sudden health issues can affect anyone at any time. In fact, Nancy Cruzan was only 25 years old when her car accident occurred. It was reported at the time that Nancy was “vivacious, active, outgoing, and independent person” prior to her accident. Whether in perfect health or facing medical challenges, proactive planning brings peace of mind to you and your loved ones.
What If You Don’t Have an Advance Directive?
If you don’t have an advance healthcare directive and cannot make medical decisions, the state’s laws will determine who makes those decisions for you. Your spouse, parents, or adult children typically may step in. However, if there’s disagreement or your family members aren’t sure what you would want, the lack of clarity can lead to disputes or decisions that might not align with your true wishes.
In Missouri, while there is no statute directly on point stating who can make decisions regarding treatment if there is no power of attorney, generally health care providers will look to the family in order of relation for authority to consent to treatment and that order in related statutes is as follows:
(1) Spouse unless the patient has no spouse, or is separated, or the spouse is physically or mentally incapable of giving consent, or the spouse’s whereabouts is unknown or the spouse is overseas;
(2) Adult child;
(3) Parent;
(4) Brother or sister;
(5) Relative by blood or marriage.
However, a provider may not grant the same authority to relatives when the issue of withdrawing or withholding treatments comes up. Just like in Nancy Cruzan’s case, not having these documents could result in prolonged legal battles or decisions that contradict one’s personal beliefs.
How to Get Started
If you are ready to take control of your future healthcare, here are a few steps to consider:
- Reflect on Your Values: Think about the medical treatments you would or would not want if you could not communicate your wishes.
- Choose a Healthcare Proxy: This person will make decisions on your behalf if you cannot do so. Choose someone you trust to follow your wishes.
- Create a Living Will and Durable Power of Attorney for Healthcare: These documents should be completed to officially state your preferences.
- Have Conversations with Loved Ones: Share your decisions with family members, friends and your healthcare provider so they are aware of your wishes.
- Review and Update Your Documents: Life changes, such as moving to a new state or changes in your health, might require updates to your directives.
Request a Consultation to Plan Your Advance Healthcare Directives
Don’t wait for a crisis; enshrine your healthcare wishes in an advance healthcare directive today. Book a Call with a Frankel, Rubin, Klein, Payne & Pudlowski attorney today, we are licensed in Missouri and our law firm services all of the St. Louis Metropolitan Area.
We are especially convenient for estate planning in Clayton, Brentwood, Des Peres, Frontenac, Glendale, Webster Groves, Kirkwood, Ladue, Maplewood, Olivette, Overland, Richmond Heights, Rock Hill, Shrewsbury, Town and Country, Creve Coeur, Affton, Crestwood, Sappington, Sunset Hills, Maryland Heights, University City, Warson Woods, and St. Louis City.
Key Takeaways:
- Plan Ahead: Anyone can face unexpected health issues; having advance healthcare directives ensures that your medical preferences are respected.
- Choose a Trusted Person: Appoint a healthcare proxy who understands and is willing to honor your wishes.
- Avoid Legal Battles: Without advance directives, your loved ones may face difficult legal and emotional challenges, as in the case of Nancy Cruzan.
- Regularly Review Your Documents: Life changes can require updates to your healthcare directives.
References: National Institute on Aging (Oct. 31, 2022). “Advance Care Planning: Advance Directives for Health Care | National Institute on Aging” and Practical Bioethics (n.d.). “The Case of Nancy Cruzan”
