There is a general consensus that having a last will and testament is important, but few people realize the necessity of having medical documents in place.

Document such as a healthcare power of attorney, living will and HIPAA authorization give individuals the right to choose who has access to protected medical information and who has the right to make decisions during incapacity.

A healthcare power of attorney is the most important and broadest of the medical estate planning documents. it may be known by other names, such as a medical power of attorney, a healthcare surrogate or a similar variation. It also can be limited in scope or can encompass both a living will and a HIPAA authorization within one single document.

A healthcare power of attorney generally makes several specific determinations. First, the document should name at least one agent, as well as a backup agent. While many people feel confident that they simply can change their choice of agent if the agent becomes unavailable, this is often not an option. If the individual has diminished capacity, such as through dementia or Alzheimer’s, or if the individual simply fails to make a change after the painful loss of a loved one, he or she may find that when most needed, no agent is available.

Without an appointed agent, court intervention is likely to become necessary.

The document also should specify at what point the agent may begin acting on behalf of the individual.

This can be broken down into two parts: access to information and ability to make decisions. Many individuals are comfortable allowing an agent immediate access to protected health information, but it is more rare for an agent to be able to immediately make decisions.

Immediate decision-making power is more common when the individual is at an advanced age or has urgent medical needs.

Other provisions also are commonly included in order to ensure the agent has the full ability to act.

For example, preferences regarding organ and tissue donation, as well as religious preferences regarding blood transfusions may be included in a healthcare power of attorney. The right to hire and discharge healthcare providers, to obtain psychiatric care or drug rehab and the ability of the agent to consent to the authorization or removal of life support are all commonly included.

A living will, also known as an advance medical directive, may be included within the healthcare power of attorney or may be a separate document.

A living will gives instructions for end-of-life decisions. These instructions may be as detailed as outlining at what times artificial nutrition and hydration may be used or as vague as simply naming an agent who has the right to remove from life support.

A living will is not an essential document — unless the individual feels that it is. If someone has strong feelings about the use of life-prolonging devices that serve only to artificially prolong the dying process, those wishes can become legally enforceable through a living will.

Finally, a HIPAA authorization, while a necessity within the whealthcare power of attorney, also may be a separate document.

A separate document is commonly used for those who want to authorize only one agent (such as one child) to make decisions, but are comfortable with multiple people having access to medical information (such as the other children).

Healthcare estate planning documents should be intentionally created to declare who will have the right to make medical decisions, as well as any specific wishes. Preparing for tough decisions in advance will make those decisions easier on loved ones when most needed.

Cynthia Griffin is an elder law and estate planning attorney at Burnett and Griffin PLLC in Elizabethtown. She can be reached at

(0) comments

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.
Terms of Use. The complete terms of use policy can be found at the bottom of this page.