- Advance directives allow you to document your healthcare plans in the event that you become unable to communicate or make your own decisions in the future.
- You can create two types of advance directives with an attorney in New York: a healthcare proxy and a living will. Additionally, when you create advance directives with a medical professional, you can create either Medical Orders for Life-Sustaining Treatment (MOLST) or a Do Not Resuscitate (DNR). The latter two advance directives are intended for those with serious health conditions who may face life-threatening medical situations.
- A health care proxy indicates who will make medical decisions on your behalf if you lack the mental capacity to do so on your own.
- You can create a Living Will to go with a health care proxy and inform your agent about which treatments to engage in or forgo if recovery is not expected.
What Are Advance Directives?
Advance directives are legal documents that allow you to express your healthcare preferences and make decisions about medical treatment in the event that you become unable to communicate or make decisions for yourself. These documents are legally binding in New York State, and can only be executed when you are of sound mind and able to make informed decisions.
The Different Types of Advance Directives
In New York State, there are two types of advance directives you create with an attorney: a healthcare proxy and a living will. In addition, there are two types of advance directives you create with a medical professional: Medical Orders for Life-Sustaining Treatment (MOLST) and a Do Not Resuscitate (DNR). The MOLST and DNR are intended for individuals with serious health conditions who may face life-threatening medical situations and want to make their treatment preferences known to health care providers.
A health care proxy is a document that states who will make medical decisions if you lack the mental capacity to make them on your own. In some states, this is referred to as a “medical power of attorney”, but in New York it is a Health Care Proxy. Some choose to sign a health care proxy when they are creating their estate planning documents. Others are prompted to sign such a document when they are going into the hospital for a procedure. A lack of mental capacity can be temporary, for example if someone is under anesthesia. A person can also suffer long-term loss of capacity from dementia or some other cognitive impairment.
Choosing a health care agent can be difficult. The best health care agent is someone who knows your wishes and who you believe will act as you would, making the choices you would make. Remember, this person is substituting their judgment for your own.
A living will is a companion document to the health care proxy and serves as the “roadmap” for your agent. A Living Will more specifically directs the substituted decision-maker in their actions. It serves as your voice when you are unable to speak for yourself and are in an irreversible state, with no reasonable expectation of recovery. The living will often directs an agent to withhold or withdraw treatments if recovery is not expected. The document can list specific treatments to be withheld, including dialysis, antibiotics, and a feeding tube.
Keep in mind that, the living will can also direct the opposite: that someone be kept alive by all measures necessary.
Common Questions About Advance Directives
Advance directives can be a complex topic for many people, and making decisions about them can be difficult. However, with clear information and helpful advice, it’s possible to plan ahead so that both you and your loved ones can have peace of mind.
What Is a DNR?
Do Not Resuscitate (DNR ) and Do Not Intubate (“DNI”) orders are created with and signed by your treating physician. A DNR refers specifically to cardio-pulmonary resuscitation. This document can be completed at the hospital, rehab or nursing facility, bedside or as a “non-hospital DNR/DNI” for those who remain in their home.
What Is a MOLST?
MOLST is a medical order that provides instructions for current treatment preferences when someone is facing serious life-threatening medical situations. A MOLST is for those that may die within one year and specifically intended for those that want to avoid life-sustaining measures. The MOLST is signed by both the physician and patient, or the patient’s designated agent. The MOLST includes specific treatment guidelines, including when to transport a patient to the hospital, in what circumstances antibiotics or artificial nutrition/hydration should be used or withheld. The healthcare professional then signs and dates the MOLST form, which becomes part of the patient’s medical record.