Medical DecisionsDo my estate planning documents cover medical decisions?

 
There are three components to your medical directives and medical decisions. These three components are:
 
  • a living will
  • a health care power of attorney
  • a mental health care power of attorney
 
You may also get the individual medical directives separately.
 

What is a Living Will – Medical Decisions

 
A living will sets forth your end of life decisions. This document works for more than a few states. A terminal condition, a persistent vegetative state or an irreversible coma and unable to communicate your medical decisions.
 
The living will states what choices you would have made for yourself if you were able to communicate. The decisions contained in a living will are often referred to as “end of life care” decisions or a “pull the plug” directive.
 
In the living will, you can elect to receive only treatment that will make you comfortable. For example, pain medication, but will not extend your life and allow you to naturally expire.
 
This prevents the use of ventilators and other machines that keep you alive if there is not a reasonable medical expectation of recovery.
 
You may also elect to have your life prolonged to the greatest extent possible.
 
These are your medical decisions to make in your living will. Your health care representative, family, doctors and others for you are bound to follow your choice.
 

Healthcare or Medical Power of Attorney

 
A health care or medical power of attorney form appoints a representative to make medical decisions for you. They can make them if you are unable to communicate your own decisions.
 
If you are in a car accident and unconscious upon arrival at the hospital, your health care representative may authorize or refuse surgery or other medical treatment on your behalf.
 
But, your health care representative is bound by the choices you made in your living will. If you are in a terminal condition, irreversible coma, or persistent vegetative state they must abide.
 
A health care power of attorney may also express your choices on other medical decisions:
  • funeral and burial disposition
  • organ donation
  • autopsy
  • and nomination of a guardian if needed
 

What is required in Arizona for medical decisions?

Arizona requires an express authorization for a health care representative to make certain mental health or behavioral decisions.
 
If you become incapable of making your own mental health care decision you may state your mental health care wishes in a mental health power of attorney. You may also appoint a mental health care representative to make decisions in your best interest that are not otherwise clear.
 
These decisions involve admission to a structured treatment setting. One with 24 hours-a-day supervision and an intensive treatment program licensed by the Department of Health Services. Commonly referred to as a “level one” or “locked” behavioral health facility.
 
For people with severe medical conditions nearing the end of their life, a Prehospital Medical Care Directive or Do Not Resuscitate Directive may be appropriate.
 
This informs emergency medical technicians or hospital emergency personnel that you should not be resuscitated. Not by the use of equipment, drugs, or devices to restart your heart or breathing.
 
There are strict requirements to make a valid Do Not Resuscitate Directive and it must be signed by a doctor or other health care provider.
 
These health care directives cover very important medical decisions and choices. Choices that will be made if you are unable to communicate.
 
We will provide you with a Health Care Options form that contains information about these decisions and allows you time to contemplate your choices.
 
We will also go over each of your choices with you when we meet so that you understand your options and we will answer every question you have.
 
We offerr caring and compassionate legal services. It could not be more evident than in guiding and assisting you with your medical power of attorney forms.
 

I have an old trust prepared in another state. Is it still valid?

In short, yes. If a will or a trust was valid pursuant to the laws of the state where it originates in effect at the time of its creation, it is still valid. But, our lives are constantly in flux. Your family situation or your wishes then may be different now than they were when you first created your will or trust.
 
Additionally, the law may have changed since you created your old will or trust providing you with more helpful possibilities. You should review your estate plan on the regular.
 
We recommend reviewing your estate plan at least every five years or upon the occurrence of a major life event within your family such as
 
  • marriages
  • divorces
  • births
  • deaths
  • changing residences
  • or moving to another state
 
We will review your family situation and wishes with you to confirm that your estate plan still meets your goals.
 
If there is a required change, a codicil to a will or amendment to a trust enoughficient. If major changes needed, we will provide you with the option of preparing a new will or restated trust. The important thing is to bring your estate plan in compliance with your goals and wishes.
 

Why can’t I prepare my own will?

Estate planning is an investment that involves more than “fill-in-the-blank” document preparation.
 
You’ll need for specific knowledge and experience to design a comprehensive, customized plan. There are many potential pitfalls and traps for the unwary in estate planning.
 
There are parties that need notification:
  • the beneficiary designations on your financial and retirement accounts
  • a qualified personal representative or trustee needs to be appointed
  • and a workable plan must be installed
 
Many contested probate actions are the result of estate planning documents not prepared well. This costs the beneficiaries much more in attorney fees in the probate action.
 
Let me give you an anecdote.  Warren Burger was the Chief Justice of the United States Supreme Court from 1969 to 1986, arguably the top legal position in the country.
 
Chief Justice Burger drafted his own will.
 
Despite his keen legal mind, Chief Justice Burger made some mistakes. These cost his family many thousands of dollars correcting the mistakes in probate court.
 
You can see how easy it is to get tripped up by a pitfall in drafting your own estate plan. If the Chief Justice of the United States Supreme Court made errors in drafting his own will, you can too.
 

What exactly is probate and why should I avoid it?

In short, “probate” is a court action where a decedent’s final affairs are completed and his estate is distributed.
 
But, probate actually consists of two actions taken by the court:
 
  • appointing a personal representative, sometimes referred to as an executor, to administer the estate
  • determination of the validity of a will left by a decedent.
 
Additionally, the probate court may determine the heirs of an estate or devisees of a will. The probate court will also determine if a bond is necessary and the amount of the bond.
 
There are a few different types of probate actions. Informal probate is the most streamlined. The probate clerk will review the application. Then admission of a will to probate and start the probate proceedings if the application appears enough on its face.
 
Informal probate is not available in some situations. Such as
 
  • when certain people apply to be personal representative
  • there are many people with equal priority for appointment as personal representative that will not waive their right to appointment
  • or when there are many un-revoked wills.
 
A formal proceeding involves an initial hearing before a judge or commissioner to consider matters that are not permissible in informal proceedings or when the probate clerk rejects the informal application on its face.

 

 

What happens if there are objections to my medical decisions?

 

If objections are made to the relief requested at the initial hearing, then a discovery schedule will be entered and an evidentiary hearing scheduled to resolve the contested matters.
 
An informal hearing will become a formal proceeding if objections are made by an interested party to the appointment of the personal representative or validity of the will.
 
In most cases, the administration of the estate by the appointed personal representative will proceed just like one initiated by informal proceedings once the issues involving the appointment of a personal representative or validity of a will are resolved with little court intervention unless there are further objections filed.
 
A supervised administration is one in which the court has a more “hands on” role in administration of the estate and supervises the actions of the personal representative. Supervised administration is permitted if the will directs it, the court finds that supervised administration is necessary for the protection of persons interested in the estate, or the court finds that supervised administration is “necessary under the circumstances.”
 
Once appointed, the personal representative has many duties to perform.
 
Before appointment, the personal representative must take two online training modules that go over the duties and obligations of the personal representative.
 
Then, the personal representative must
  • notify interested persons of his or her appointment and/or admission of the will to probate
  • determine if any statutory allowances are applicable, provide actual notice to know creditors of the decedent
  • publish notification to unknown creditors in a local publication
  • prepare an inventory and appraisement of the estate assets
  • file the decedent’s final personal income tax return and any estate tax return if necessary
  • determine the validity of claims received by creditors and dispute claims that may be invalid
  • pay valid debts and expenses
  • respond to inquiries from people interested in the estate
  • distribute the remaining assets to those entitled to them
  • and, finally, close the estate either formally or informally.
Probate is a lot of work! You can see why we recommend setting up an estate plan that will avoid probate proceedings.