HEALTH CARE DIRECTIVES FOR COLLEGE STUDENTS AND ADULTS
Parents face many challenges when their children leave home and go to college. Aside from the emotions of leaving home, parents have to deal with tuition payments, moving their child into their first dorm, and such. But as children grow into young adults (and in Alabama, a person is deemed an adult at the age of 19), it is a time for children to begin making their own life decisions.
While most 19 year olds do not have enough assets to require a Last Will and Testament, an Advance Directive and Health Care Proxy and a Medical Power of Attorney are another matter. Without an Advance Directive and Health Care Proxy and Medical Power of Attorney, the parent of a child who has reached the age of majority (again, that is 19 in Alabama) cannot make certain medical decisions for their child. Please understand this can be a delicate topic for many, but due to the important legal implications of these decisions, the remainder of this blog contains a frank and direct discussion of this issue.
The first thought that comes to everyone’s mind is a tragic situation following a horrible accident where the victim remains alive only through life sustaining medical treatment. However, situations which also warrant the need for an Advance Directive and Health Care Proxy and Medical Power of Attorney can also arise from a terminal illness or injury or a permanent unconsciousness. In such situations, without an Advance Directive the State of Alabama and medical providers will follow the protocol of continued medical treatment, even it only means delaying an impending death.
In Alabama, an adult may make an election to withhold life sustaining medically indicated health care treatment and/or artificial nutrition and hydration (i.e., a feeding tube). This decision applies in two situations: (1) a terminal illness or injury, and (2) a permanent unconsciousness. In a terminal illness or injury situation, an individual’s physician and another physician who is not the physician of the individual must determine that the individual has six months or less left to live, and medically indicated health care treatment will not cure the individual but only prolong the dying process. In a permanent unconsciousness, the individual’s physician and another physician who is not the physician of the individual must determine that the individual has no indication of mental function, and medically indicated health care treatment will not cure the individual but only maintain the individual in a permanent state of unconsciousness.
In either of these situations, an adult in Alabama may make an election to terminate any medically indicated health care treatment. In addition, the individual may also make an election to forego artificial nutrition and hydration. This is called an Advance Directive.
Alabama also allows an adult to specify an individual who can make medical decisions on behalf of the individual when the grantor is incapacitated or otherwise incapable of making their own health care decisions. The need for this authority certainly arises in the two situations involving the use of an Advance Directive, but more typically the need for this authority can arise in a simple surgery where the grantor will be under anesthesia. For out of state parents, this could be a critical instrument if their child become seriously sick or injured while away at school.
Another recommended instrument is a Medical Power of Attorney. Medical Power of Attorney allows the agent of the grantor of the Power of Attorney to authorize or withhold medical treatment, to obtain medical records, sign medical documents, and so forth. It is important to understand that a Medical Power of Attorney will not address end of life decisions like an Advance Directive and Health Care Proxy does. Therefore, we recommend the use of both instruments.
These are important decisions that young adults and their parents should talk about and discuss. But it is important to understand that a health care decision to not continue medical treatment should be in writing and prepared after consultation with an attorney who understands these issues.
At the Law Offices of Thomas J. Skinner, IV, LLC, we understand these issues. Unfortunately, we have had to face these decisions in our personal lives, and we can attest to the importance of an Advance Directive and Health Care Proxy. If you have questions and would like to discuss an Advance Directive and Health Care Proxy or a standard Power of Attorney or a Last Will and Testament, contact us at 205-802-2545.