How Is a Medical Power of Attorney Different from a Living Will (Health Directive)?

Planning for medical possibilities goes far beyond merely buying health insurance.  Your plan may include making sure you are well protected today, with health, life and disability insurance.  It may also include preparing for later, with a will and estate plan.  As part of your estate planning, it’s also important to make decisions in regards to your future health care. 

You have likely heard different terms to describe having your medical needs met when too sick to care for yourself.  Depending on the state you are in, the documents may have different names and requirements.  Essentially, in order to manage your health care once you can no longer speak for yourself, your need two types of documents: a living will (AKA advance health directive) and a medical power of attorney

Living Will/Advance Health Directive

A living will is a set of detailed instructions describing how you wish to have your health care managed in dire situations.  Also known as an advance health directive or physician’s directive, it is only to be used if you are unable to speak for yourself due to terminal illness or incapacitation. 

In your living will, you would explain your preferences for different life prolonging treatments.  This document often lists the specific treatments you do not want to receive.  You can specify, for example, if and how you want to be resuscitated.  You can also give instructions on the use of artificial respirators, blood transfusions and other life-sustaining measures.

In addition to what you don’t want, a health directive can also list treatment that you do want administered if appropriate for your situation.  Pain management, for example, may be addressed.  Your position on other issues such as organ donation may also be included.

Living wills follow differing state laws, and it’s crucial you use a state-specific living will.  As it is a complex and binding legal document, it must be signed, witnessed and in some cases notarized. 

Medical Power of Attorney

A medical power of attorney (or health care power of attorney) is a legal document which designates one person, an agent, to make decisions on your behalf in case of serious illness or incapacitation.  If you cannot speak for yourself, your agent has the authority to make your health care decisions.  They are responsible for communicating with your doctors and clarifying your choices.

This document is a specific type of power of attorney.  It does not give the agent the power to make decisions about financial or legal matters.  Only medical matters are addressed, and only once you are unable to make your own decisions.

The person you choose to be your agent literally has the responsibility to make your life and death decisions for you – only choose someone you fully trust.  He or she will need to be able to make emotional and difficult decisions and carry out your wishes.  Depending on your requests, your closest family member may not necessarily be the best person to choose as your power of attorney.  It may be hard for your spouse or mother, for example, to comply with your desire to be taken off a respirator.  Once you have written up your document, speak to your family about your wishes, so they know in advance what to expect should anything happen to you.

A medical power of attorney must be legally drawn up, signed and witnessed.  Check with local state laws to see the list of requirements, and always use a state-specific health care power of attorney. 

In some states, medical decisions can be included under a durable power of attorney.

Living Will or Medical Power of Attorney?

In order to properly protect yourself, you need both a health directive and a health care power of attorney.  The health directive document does not appoint someone to make your health care decisions.  Having both of these legal documents in place avoids the courts from having to appoint a guardian to make health related decisions on your behalf. 

It’s important to review both documents every few years, or after a life event.  Since circumstances change, it’s a good idea to make sure your written instructions still align with your personal beliefs. 

You may also choose to name a secondary agent in your health care power of attorney.  If your primary agent is unavailable or unable to act for you, the secondary agent may step in.  Both documents can be changed or revoked at any time, as long as you are still of sound mind.  Keep your documents in safe place.  Tell your family and your agent where to find both documents; they should be easily located should the need arise.