Health Care Directives: One More Thing to Have In Order

A health care directive is a core document for an estate plan. My recommendation is if a person is over age 18 and has capacity, they should consider making a health care directive to appoint someone to make health decisions for them, and to give instructions on how they want medical decisions to be made for them.

Minnesota Statutes Chapter 145C provides a person with the authority to make a health care directive in Minnesota. In the past, health care directives were called living wills and durable powers of attorney for health care. These documents can still be used if these were validly created prior to Aug. 1, 1998, or if the document has the elements of a valid health care directive under Minnesota Statutes Chapter 145C.

A common topic that comes up when making health care directives is how to give instructions for medical care when a person is in a terminal condition. Some people give instructions that say they do not want treatments that constitute “heroic means” or “life support.” However, many people do not realize that these instructions are not the same as a “do not resuscitate” order and a “do not intubate” order.

DNR/DNI orders are medical orders signed by a doctor that say not to administer cardiopulmonary resuscitation and intubation if your heart stops or you stop breathing. Unless you have these orders, medical staff and emergency medical technicians are required to attempt to help a person whose heart has stopped or has stopped breathing by administering life-sustaining treatments such as CPR.

When you need a doctor’s signature

If you do not want to receive resuscitation or intubation in the event of an emergency, you will need to have a DNR/DNI order in addition to your health care directive. A DNR/DNI order must be done with a doctor or medical professional who can explain what the order means and is able to sign the order. It is recommended that if you have a DNR/DNI order you keep it near you, so it is available in the event of an emergency. Some people will keep the DNR/DNI order in the refrigerator at home or in their purse. Some will also wear a necklace or bracelet showing that they have a DNR/DNI order to look for.

Another document that should be considered is a Physician Orders for Life-Sustaining Treatment. This is a more-detailed order that covers other types of treatments and procedures besides those covered by a DNR/DNI order.

I recommend discussing each of these documents with your physician to make sure your wishes are covered.

This article appeared in the February 2023 issue of The Farmer magazine.