By Dr. Anthony Policastro

There are two medico-legal documents that are often confused. Both are documents that every family should have. Unfortunately, that is often not the case. Only about 35 percent of individuals have these documents. That percentage has not changed in years.

The first one is what is called a medical power of attorney. This appoints someone to make medical decisions for you if you are in some way incapacitated and cannot do so yourself.

There are many instances where this can happen. Someone may be in an accident and not be able to make decisions because of the injuries, this is especially true if there is a head injury.

There are also situations that can occur during medical procedures. Once someone undergoes anesthesia, they are no longer awake enough to make medical decisions. If there is something unexpected found at surgery there might be a need to have a loved one make a decision before the anesthesia is worn off. The same might be true if there is a complication of surgery.

Accidents are not predictable. Surgical procedures are often not predictable. A power of attorney is necessary to allow input into any decisions that need to be made when the individual cannot do so themselves. (The lawyers would tell you that a financial power of attorney is a good idea for these circumstances as well)

Therefore, every adult should have a person named to help make decisions if one of those situations arise. That means that if you are an adult and do not have one of these documents, you do not really care what medical decisions might be made under those circumstances. About 65 percent of adults fall into that category.

The other document is something that is more familiar. That is the one known as a living will. This document makes known what you would like to have done in extreme circumstances.

The main difference is that this document only can take effect if you have a qualifying condition. At one time there were two qualifying conditions in Delaware. One was terminal illness, and the other was permanent unconsciousness. 

A third one has been added. It reads that the patient suffers from a serious illness or frailty that may cause them to die within the next year.

Any of the three requires a doctor(s)’ certification of its presence in order for the living will to take effect. The document lists those things that the individual would or would not want done at the time the certification takes place.

In most cases these situations occur in older individuals. However, that is not always the case. Therefore, everyone should have one of these on file with their physician. Some people are afraid that means that if they get sick at all, care will not be given. That is not true. 

For example someone might want that they do not want to be intubated. However, if they develop an acute illness, they might need to be put on a ventilator for a short period. This is not a qualifying condition so they would get the temporary care that they need.

The document only becomes effective when one of the qualifying conditions is documented in the official medical record. Again only 35 percent of individuals see the need for this document. 

Both documents are really necessary. They do completely different things. It is time for the other 65 percent of the population to take action.