Advance Medical Directives

Take Control of Your Health Care Decisions

Advance medical directives are the best way for you to take control of your situation in the event you become gravely injured or incapacitated.  Advanced medical directives are powerful legal tools that enable you to:

  • Dictate the types of medical treatment you do and do not want
  • Determine the individuals you would like to be in charge of making important decisions regarding your medical treatment or care if you become unable to do so
  • Set forth the circumstances under which you would prefer to curtail or cease medical treatment and,
  • Decide who you would like to visit you and have access to your medical records if you are seriously injured or incapacitated.

There are several different types of advanced medical directives and determining which one(s) are right for you can be confusing.

If you need assistance crafting a living will or another advanced medical directive, turn to The Law Office of Keenan Copple PC for help. We’ll guide you through the process, explain your options, and work with you to create a will that can give you peace of mind that your family will know what to do in the future.

Schedule your confidential consultation with Keenan Copple today by calling (303) 819-6415 or by reaching out to us online.

Types of Advance Medical Directives

As an adult, you have the right to consent or refuse medical treatment. You can also dictate your wishes in writing if you’re unable to communicate for any reason. Making your wishes known can be very helpful for both doctors and family members. It’s important to note that signing an advance medical directive doesn’t take away your right to dictate the care you receive if you are still capable of making those decisions, but it will be an extremely helpful instrument if you can’t.

Keenan Copple can assist you with advance medical directives including:

Living Wills

Patients tend to be most familiar with the “Declaration as to Medical or Surgical Treatment” directive, more commonly referred to as a living will. This document dictates your wishes when it comes to the administration, withdrawal, or withholding of life-saving procedures and treatment (otherwise known as life support).

These directives usually come into play if your condition is terminal, if you’re in a persistent vegetative state, or are unconscious and otherwise incompetent. Depending on your wishes, in this limited set of circumstances, doctors could administer or withhold :

  • Artificial hydration
  • Artificial nutrition
  • CPR
  • Defibrillation
  • Medications
  • Surgery

The primary difference between a Living Will and a Medical Power of Attorney is that the Living Will is “self-executing.” In other words, it can be effective without another person making any decisions on your behalf; you made the decision up front. As long as the document is available or made available to your medical providers, they are supposed to follow its instructions and the procedures set forth in the law, and either remove or continue life support as you have instructed.

Medical Power of Attorney

With a Medical or Health Care Power of Attorney, you can designate someone you trust as your “Agent” to make medical decisions for you when you can’t make them yourself. This is different from a Living Will in that your agent’s authority does not apply only in cases of terminal illness or a persistent vegetative state (but they do have to follow the wishes expressed in a Living Will, if one exists and you have specified the Living Will trumps your agent’s authority).

Your agent will be the decision-maker that doctors will release information to and rely on for directives regarding care and treatment. You can grant them broad or limited authority, and can give specific guidance regarding your wishes, and can amend or revoke the POA at any time.  You may appoint whoever you trust: your partner, an adult child, a trusted friend or sibling.  If you do not have a medical power of attorney, the hospitals and courts will look to your spouse or other close familial relation and they may or may not be who you would want making your healhcare decisions.

We typically include this document with every estate plan because it may eliminate the need to initiate a court proceeding and have a formal guardian appointed if you become incapacitated. It also allows the client the ability to designate who will make medical decisions for them up front, as opposed to leaving that choice to a court and their family members.

CPR Orders and DNR (or Do Not Resuscitate) Orders

If you do not have a CPR or DNR directive in place, a medical professional will automatically assume that you want CPR. A DNR is a “stop sign” that tells paramedics, doctors, or nurses that you do not want CPR or other methods of resuscitation administered if your breathing or heartbeat stop. If you have a DNR, it means intubation, defibrillation, and chest compressions will not be performed,

Because DNR’s apply to both terminal and non-terminal patients, regardless of the circumstances under which the patient becomes unconscious or stops breathing, DNR’s are not appropriate for young, healthy people, in my opinion.

They are appropriate for people with a terminal health condition who do not want paramedics to intervene if they stop breathing naturally or for very elderly people with that same wish.

To effectively put a DNR in place, the client must fill out a specific form distributed by the Colorado Department of Health through the Colorado Medical Society, which must be signed by your physician.

Then you should order a bracelet or necklace which serves as the means of notification in an emergency response situation. Some individuals also place a copy of their CPR directive prominently in their home the front door or the refrigerator are some good options. We will be happy to help you put a valid DNR Directive in place if you feel that it is appropriate for your situation.

Medical Orders for Scope of Treatment

This is a document that is prepared with your physician that allows you to direct what medical treatments and procedures you wish to undergo or forego.

Like the CPR Directive, this form is generally only appropriate for very elderly or ill individuals.  This is because it is somewhat foreseeable what medical issues and resulting treatments may arise with very elderly people or those with a serious known medical condition.

For most healthy people, this type of advanced directive could become an unmanageable, sprawling choose-your-own-healthcare-adventure. However, please let me know if there are very specific treatments or procedures you do not wish to undergo for religious or other reasons and I can ensure that we provide for those wishes.

Form for Disposition of Last Remains

You have the right to specify, within reason, your desired disposal of your last remains, and are protected by Colorado law from individuals who wish to impose their views over the wishes you’ve stated. Colorado statutes provide a form for Disposition of Last Remains for you to specify your wishes.

You could also declare them in a will, prepaid contract for a funeral, burial, or cremation, in a living will or medical power of attorney, or a Designated Beneficiary Agreement, according to the Colorado Bar Association’s guidelines on Advance Medical Directives.

In the absence of specific instructions, your Personal Representative, designated under your Will, will make the decisions regarding burial, cremation, etc.

If you have specific desires regarding the disposition of your last remains, please let us know so that they can be appropriately set forth in your estate plan.

Additional HIPPA Disclosures

You have likely signed releases or other documents at your doctors office that are related to HIPPA. HIPPA is a federal statute that seeks, among other things, to protect people from unwanted disclosure of their medical history or information.

However, in practice, HIPPA can be a bit of a stumbling block by preventing doctors from discussing your medical situation with others (like your medical agent, personal representative, financial agent, or family members). With careful drafting we will ensure that your medical agent, personal representative, and financial agent can get the information they need about your medical condition, bills and records.

However, you may wish to authorize your health care providers to discuss your prognosis and medical condition with others who are not listed as fiduciaries in your estate planning documents. This may be particularly important in end-of-life situations or if you are incapacitated.

For example, you may want your doctors to be able to speak with your siblings, parents, romantic partner, children or other family members in these situations. Allowing these non-decision makers to speak to your doctors may eliminate conflict and strife in the unfortunate event that your medical agent has to decided to discontinue treatment.

Please let us know if there are people that you would want to be able to speak with your doctors about your condition and we will include the appropriate form in your estate plan.

Proposition 106

Beginning in 2017, Colorado residents achieved the statutory right to obtain medication to end their life if they are terminally ill and two doctors certify they have six months or less to live.

There are many requirements that must be met before this type of medication can be dispensed.  However, one important consideration is that under the statute, the terminally ill patient must make the necessary verbal and written requests for such medication herself and also must self-administer the medication.

Therefore, a person must be competent both to make the decision to pursue this end-of-life option, and to self-administer the medication.  This means that this decision and responsibility can’t be delegated to your medical agent under your Medical Power of Attorney or other advance medical directives.

Contact Us Today

Do you have additional questions or are you ready to begin the process of taking control of your medical future? We’ll help you craft the advance medcial directive(s) that will help your family and medical professionals know what to do in the event that you become incapacitated.

Attorney Keenan Copple has been helping people in Denver and across Colorado with their estate planning needs since 2012. She will take the time to get to know you and your family and will help you craft a living will that is clear, understandable, and actionable to save your family significant stress and strain if a situation arises where they need to consult it.

Call (303) 819-6415 or contact us online to schedule a completely confidential consultation with Keenan today.

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