Who makes health care decisions on my behalf if I cannot?

In Oregon, a legal document called an Advance Directive gives you a voice in your medical care in the event you become unable to make your own health care decisions.  For this reason, we recommend that our clients execute an Advance Directive as part of their healthcare and end of life planning.

The Advance Directive allows you to appoint a Health Care Representative to make healthcare decisions for you.  In selecting the Health Care Representative, you may want to consider who you trust to make decisions consistent with your wishes, who you believe will be available to step into that role, and who will keep your best interests and wishes in mind.  It is a good idea to appoint both a primary Health Care Representative and an alternate Health Care Representative, in the event the primary representative is unavailable to serve.

A Health Care Representative cannot choose to end your life under Oregon’s Death with Dignity Act or take any overt action to end your life.

The Health Care Representative you select will have the legal power to make healthcare decisions, but only if you are unable to do so.  Once you sign an Advance Directive, you continue to have the right to make your own decisions.  However, once you become unable to make a health care decision on your own, the Health Care Representative steps into that role.  Reasons an individual might not be able to make their own decisions may include chronic conditions such as Alzheimer’s disease, or temporary conditions, such as falling unconscious.  In all events, the Health Care Representative may only make decisions about health care.  The decision-making power does not extend to other areas of your life, such as financial decision-making.

If you do not have an Advance Directive, your health care providers will rely on others to make decisions on your behalf.  Under Oregon law, if an individual does not have an Advance Directive, then the following individuals have priority for health care decision-making:  legal guardian, spouse, majority of adult children, and then close friends.  Those individuals may be who you would choose as your Health Care Representative. However, without written instructions, those individuals may not know your wishes. Thus, taking the time to complete an Advance Directive provides those you love the guidance they will need to honor your wishes.

Once you have signed an Advance Directive, you should:

  • Give a copy of the Advance Directive to your physician for your medical records and discuss your decisions with him or her.
  • Share your wishes with and give a copy to your Advance Directive to your Health Care Representative and alternate Health Care Representative.
  • Keep your signed, original Advance Directive where it can be easily found and let loved ones know where it is.  Do not keep it in a safe deposit box or other location that requires a key or authorization.
  • If you have to be admitted to a care facility or hospital, take a copy with you to be placed in your chart or medical file.

Communicate your wishes to your Health Care Representative. Your Health Care Representative has a duty to act consistently with your desires as expressed in you Advance Directive or with your desires as communicated at any time to the representative. If the Health Care Representative does not know your wishes, then the representative must make decisions in good faith based on what he or she believes to be your best interests. For these reasons, it is important to communicate your wishes to your representative. For example, you might discuss where you would want to die if given a choice — such as at home, in hospice care, or at a hospital or care facility. You might want to share your thoughts about quality of life and what it means to you. Or, you may want to share your thoughts about other values, such as prolonging life, knowing your family, managing pain, or financial matters related to health care.  For some individuals, discussing religious beliefs and decision-making that is consistent with those religious beliefs is important.

If you change your mind and wish to revoke an Advance Directive, you may do so. However, you must communicate your decision to revoke the Advance Directive directly to your physician, health care provider, or your Health Care Representative.

Please contact us for a free initial consultation if you need an Advance Directive or if you need to plan your estate or update an existing estate plan.  

Phone: 503-639-6176 or Email: contact@parianilaw.com


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