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Understanding Advanced Directives in a Comprehensive Estate Plan

by Dan A. Baron, Baron Law LLC

Estate planning encompasses not only the distribution of assets after death, but also critical healthcare decisions in the event of incapacity. In Ohio, advanced directives function as crucial legal instruments that enable individuals to articulate their medical preferences and designate trusted decision-makers. These directives ensure that healthcare providers and family members adhere to an individual’s wishes when direct communication is no longer possible. The following types of advanced directives are each essential components of a comprehensive estate plan. 

Living Will 

A Living Will is a legal document that delineates an individual’s preferences for medical treatment in cases of terminal illness or permanent unconsciousness. This document specifically addresses life-sustaining treatments such as mechanical ventilation, artificial nutrition, and hydration. A Living Will takes effect only when an individual is incapacitated and is also in a terminal or permanently unconscious state, directing healthcare providers to follow predetermined preferences regarding life-prolonging treatments. Additionally, it can include do-not-resuscitate (DNR) orders and becomes irrevocable once the individual is deemed incapacitated. 

Healthcare Power of Attorney 

A Healthcare Power of Attorney (HCPOA) allows an individual, known as the principal, to appoint a trusted person, referred to as the agent or attorney-in-fact, to make healthcare decisions on their behalf when they are no longer capable of doing so. This directive covers all medical decisions, not solely end-of-life care, and becomes effective once the principal is deemed incapable of making healthcare decisions. The designated agent is authorized to consent to or refuse treatment, access medical records, and make determinations regarding long-term care. Unlike a Living Will, an HCPOA can be revoked at any time while the principal retains mental capacity. 

DNR 

A Do Not Resuscitate (DNR) order is a medical directive instructing healthcare providers to refrain from performing CPR or other life-saving measures if an individual’s heart ceases to function or they stop breathing. This order must be issued by a physician and is classified as either a DNR Comfort Care (DNR-CC) or DNR Comfort Care Arrest (DNR-CCA), depending on the specific circumstances under which the order takes effect. Commonly utilized by individuals with terminal illnesses or those wishing to avoid prolonged suffering, a DNR order may be incorporated into a Living Will or maintained as a separate directive. 

Mental Health Advanced Directive 

A Mental Health Advanced Directive enables an individual to specify preferences for mental health treatment, including medication, hospitalization, and therapy, in the event they become incapable of making such decisions due to a mental health crisis. This directive ensures that mental health treatment aligns with the individual’s predetermined wishes and allows for the designation of a trusted agent to make mental health decisions. This is particularly beneficial for individuals with a history of mental illness who wish to retain some degree of control over their treatment. 

Organ Donation 

An Organ and Tissue Donation Declaration permits individuals to indicate their preferences regarding organ and tissue donation after death. This directive may be included in a Living Will or recorded on a driver’s license, ensuring clarity regarding organ donation intentions and facilitating timely adherence to these wishes by medical professionals. 

Importance 

While advanced directives primarily govern medical decisions, they constitute an essential component of a well-structured estate plan. These directives uphold personal autonomy by ensuring that an individual’s medical preferences are honored even when they cannot express them. They alleviate the burden on family members by preemptively resolving difficult medical decisions, thereby reducing the likelihood of familial conflict. Furthermore, advanced directives prevent the administration of unwanted medical treatment by providing clear instructions to healthcare providers. Designating a healthcare agent through an HCPOA legally safeguards decision-makers, minimizing the risk of legal disputes among family members. Additionally, integrating advanced directives into an estate plan aligns healthcare deciensuring that resources are allocated in accordance with the individual’s intentions. 

The implementation of advanced directives within an estate plan necessitates several critical steps. Consulting an estate planning attorney is imperative to ensure compliance with Ohio law and alignment with an individual’s broader estate planning objectives. Informing family members and healthcare providers about the existence and location of advanced directives enhances accessibility and facilitates timely adherence to the individual’s wishes. Regular reviews and updates to these documents are necessary to accommodate life changes, medical advancements, and modifications in state law. Storing these directives in accessible yet secure locations and providing copies to healthcare agents, family members, and medical professionals ensures their availability in emergencies. Finally, integrating advanced directives with other estate planning documents, such as wills, trusts, and financial powers of attorney, establishes a cohesive plan that addresses both medical and financial contingencies. 

Conclusion 

Advanced directives represent a vital element of comprehensive estate planning, allowing individuals to articulate their healthcare preferences and designate trusted decision-makers. In Ohio, legal instruments such as Living Wills, Healthcare Power of Attorney, DNR orders, and Mental Health Advanced Directives provide clarity and legal protections in times of incapacity. By incorporating these directives into an estate plan, individuals can ensure that their medical preferences are respected, reduce the burden on loved ones, and safeguard their medical and financial interests. Engaging an estate planning attorney and conducting periodic reviews of these documents are essential measures to maintain an effective and legally sound plan for the future. 

For more information or to schedule an appointment for a free consultation, email me at dan@baronlawcleveland.com or call us at 216-573-3723. 

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Baron Law LLC
Crowne Centre, Suite #600
5005 Rockside Road
Independence, Ohio 44131
216-573-3723
www.baronlawcleveland.com

Opinions and claims expressed above are those of the author and do not necessarily reflect those of ScripType Publishing.