Health Proxies; End of Life Decisions; Death Panels

Health Proxies; End of Life Decisions; Death Panels

By: Martin M. Shenkman, CPA, MBA, JD

Health Proxies; End of Life Decisions; Death Panels


Money Matters Radio – Estate Planning Checklist




While the health care reform debate continues, there has been much talk of end of life care and consultations, palliative care, hospice, and the ethical and moral issues these discussions raise. Whatever the outcome you need to take action by communicating your wishes in your living will and designating an agent to make decisions under your health care proxy (also called medical directive). A key to assuring your wishes are carried out is picking and preparing the appropriate health care agent. Here’s a checklist of ideas to consider:


Agent’s Knowledge: Choose a person best equipped to make the decisions, not someone you feel obligated to choose because of their relationship to you, or because of their expectation.

Agent’s Religious Beliefs: Your agent should not have religious beliefs that would be compromised by carrying out your wishes. Too few people ignore religious issues altogether when they select an agent. Of those that consider religious issues they focus on their own beliefs. While that is important (see below) even more important is that your agent not have religious beliefs that would prevent him or her from carrying out your wishes.

Your Religious Beliefs: Your agent must understand your religions or philosophical beliefs as they pertain to end of life decisions. It is not merely enough to state in your living will that you do or don’t have a particular religious perspective, you need some specifics. Ideally, you should have that discussion with your agent.

Your Near End of Life Feelings: Health care agents will often have to decide more than just “pull the plug” issues. Your feelings about hospice and palliative care, experimental treatments, pain relief and more are all important to address in the living will that will guide your agent. But ideally you should discuss these matters with your agent so that they understand your feelings.

Agent’s Intestinal Fortitude: End of life decisions aren’t easy. Will your agent have the ability to really listen to what could be tough, even horrible, news and pretty gruesome discussions with your physicians so that they can make informed decisions? If your agent will be squeamish they won’t be able to really listen to and understand the tough decisions they will be called on to make.

Geographic Considerations: Does your agent live local? Will they be able to get to the hospital if needed? Do they have a busy travel schedule?

Successor Agents: Name additional agents in case the preceding named agent cannot serve.

Single Agent: Never name more than one agent to serve at a time. In some states it might invalidate your health proxy. In many, perhaps most, situations it will make decision making impossible. If you have three children and are naming them sequentially, consider the impact.

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