Monday, January 28, 2008
LEGAL TOOLS THAT GIVE YOU CONTROL AT THE END OF YOUR LIFE
Legal Tools That Give You Control at the End
Many people have fears about ending up incapacitated, unconscious and sustained only by the mechanical rhythms of life?support equipment. But even then, the law lets you control your own situation, by means of advance directives. They come in two forms, and almost every state authorizes at least one of them. Health Care Power of AttorneyPowers of attorney are described at length in the preceding section, but this particular variety is worth noting again because it lets you designate a person who shares your beliefs to be your agent and make health care decisions when you can't. Every state except Alabama and Alaska authorize holders (or agents) of health care powers of attorney to withhold or withdraw life support. Appointing this person is especially important if you believe that some of your family members may be reluctant to honor your wishes. Many states forbid naming more than one agent to share in the decision making. But it's a good idea to choose an alternate person to make sure that someone is available when needed.A Living WillYour other option is to write a living will. Forty seven states and the District of Columbia have laws governing this written document in which you instruct your family and/or doctors about your wishes regarding life support. (Massachusetts, Michigan and New York don't have explicit laws validating living wills, but their state courts have upheld them as legal documents.)Most living will laws apply only if you are terminally ill or permanently unconscious, and they generally state that life sustaining technology should not be used to prolong life. In some states, the living will of a pregnant woman will not be honored.Many experts favor executing both a living will and a health care power of attorney to ensure the best protection of your rights.The specifics of a living willA living will has two distinct parts:
First, it says specifically when the instructions included in it become effective, based on your medical condition and prognosis for example, only if you are permanently unconscious or terminally ill.
Secondly, it names what course of life sustaining action you want or don't want followed if you should end up in such a state, including: artificial nutrition and hydration (a feeding tube or intravenous fluids), mechanical ventilation (a respirator), resuscitation (including CPR), antibiotics, and kidney dialysis. As crucial as a living will is, you probably won't need a lawyer to draw one up. Preprinted forms for writing a living will and for designating a health care power of attorney that are tailored to the laws of every state are available free of charge from the advocacy group Choice In Dying.If you live part of the year in another state, be sure to complete forms for both states.You can generally add to the forms, adapting them to your specific needs and concerns. It's a good idea to discuss possible additions with your doctor or with Choice In Dying. That will help you avoid writing your wishes in such a way that you accidentally preclude treatment you would want or permit treatment you don't want.In any event, discuss your plans and options with your family physician to make sure you understand the medical ramifications of your decisions and that the doctor understands and agrees with your wishes. Make sure, too, that he or she practices at hospitals that will uphold them. If not, you might want to change doctors. While most states have their own variation of a living will law, all states and the District of Columbia grant civil and criminal immunity to doctors who act in accordance with a living will. But they are not legally bound to.If there's an emergency, you may be attended by an unknown doctor who won't abide by your wishes written or otherwise. The following steps are worth trying, though they may be difficult in practice, especially in a critical care situation: Your family could bring in your family physician as a persuasive force, find another physician at the hospital who will agree to relieve the attending physician (the physician of record), or transfer you to another hospital.As with conferring power of attorney (discussed above), you should make a living will when you're of sound mind, that is, able to make decisions on your own behalf. Most states require two adult witnesses who aren't relatives be present at the time you sign the living will. In some states, people who stand to benefit from your death, such as heirs and insurance beneficiaries, are not allowed to be witnesses.Once you've written your living will, it's a good idea to review it every year or so. If it no longer reflects your wishes, you should change it or revoke it entirely by writing a new one. Make sure all your family members, other appropriate people and your doctors have copies, and ask your doctor to include a copy in your medical records.Click here to learn about help that is available for elders. Help Your Family Help YouIt's probably not enough just to prepare these legal expressions of your wishes. Take the time to personally discuss them with your family. A clear understanding of your intent will help everyone more easily honor your wishes. You can help eliminate any second guessing and avoid the interference of an uninformed or disapproving relative who could otherwise cause conflict and delay. You could even relay your instructions in a conversational way on videotape.If You Leave No InstructionsIn some states, if there is no clear and convincing proof of your desires, you must be kept on life support. In others, if you haven't written a living will and have not given someone durable health care power of attorney, the medical decisions will fall to your next of kin. He or she will have the legal right to tell doctors whether to pursue so called extraordinary measures to keep you alive.Which relative has seniority? The responsibility falls first on a guardian, if one has been appointed through the intervention of a family member or the state; if no guardian has been appointed, then it falls to a spouse; if no spouse, then to adult children; if none, then to a parent, if one is alive.While the decision rests with whoever ranks first in this chain of command, if someone lower down disagrees with the stand in's health care decision, any action must be postponed if possible until he or she can go to court and contest the decision. So, for example, if a desperately ill patient's adult children don't agree with her spouse about her care, they can ask a court to block the spouse's decision for the parent's medical care.In the other half of the states, the laws are vague regarding the next of kin's rights to make deathbed decisions. There is a presumption that they have the right, but an attending physician is not bound to abide by their decision. If the doctor does not accede to the next of kin's wishes, however, then the spouse or adult children may have to find another doctor or go to court.For more information on your state's law, call Choice In Dying (click here for their number). For More Information
Choice In Dying (formerly the Society for the Right to Die; 200 Varick St., 10th Floor, New York, NY 10014 4810; 800 989 9455, 212 366 5540). This non profit organization works for the right of patients to make their own medical decisions at the end of life and provides information on the issues surrounding terminal care. Call to receive free, state specific documents with which to write an advance directive and durable health care power of attorney.
The Hemlock Society (P.O. Box 11830, Eugene, OR 97440; 800 247 7421). Provides information and support to terminally ill patients regarding voluntary euthanasia.Help for Elders
National Association of Area Agencies on Aging (1112 16th St., N.W., Suite 100, Washington, DC 20036; 800 677 1116). The association's Eldercare Locator service can direct you to the closest agency on aging. It will also provide information on services ranging from legal assistance and housing options to adult day care and home health services.
National Academy of Elder Law Attorneys (1604 N. Country Club Rd., Tucson, AZ 85716; 602 881 4005). The academy can provide a free copy of Questions and Answers When Looking for an Elder Law Attorney. The organization won't give direct referrals to attorneys, but it sells its membership directory for $25.
Many people have fears about ending up incapacitated, unconscious and sustained only by the mechanical rhythms of life?support equipment. But even then, the law lets you control your own situation, by means of advance directives. They come in two forms, and almost every state authorizes at least one of them. Health Care Power of AttorneyPowers of attorney are described at length in the preceding section, but this particular variety is worth noting again because it lets you designate a person who shares your beliefs to be your agent and make health care decisions when you can't. Every state except Alabama and Alaska authorize holders (or agents) of health care powers of attorney to withhold or withdraw life support. Appointing this person is especially important if you believe that some of your family members may be reluctant to honor your wishes. Many states forbid naming more than one agent to share in the decision making. But it's a good idea to choose an alternate person to make sure that someone is available when needed.A Living WillYour other option is to write a living will. Forty seven states and the District of Columbia have laws governing this written document in which you instruct your family and/or doctors about your wishes regarding life support. (Massachusetts, Michigan and New York don't have explicit laws validating living wills, but their state courts have upheld them as legal documents.)Most living will laws apply only if you are terminally ill or permanently unconscious, and they generally state that life sustaining technology should not be used to prolong life. In some states, the living will of a pregnant woman will not be honored.Many experts favor executing both a living will and a health care power of attorney to ensure the best protection of your rights.The specifics of a living willA living will has two distinct parts:
First, it says specifically when the instructions included in it become effective, based on your medical condition and prognosis for example, only if you are permanently unconscious or terminally ill.
Secondly, it names what course of life sustaining action you want or don't want followed if you should end up in such a state, including: artificial nutrition and hydration (a feeding tube or intravenous fluids), mechanical ventilation (a respirator), resuscitation (including CPR), antibiotics, and kidney dialysis. As crucial as a living will is, you probably won't need a lawyer to draw one up. Preprinted forms for writing a living will and for designating a health care power of attorney that are tailored to the laws of every state are available free of charge from the advocacy group Choice In Dying.If you live part of the year in another state, be sure to complete forms for both states.You can generally add to the forms, adapting them to your specific needs and concerns. It's a good idea to discuss possible additions with your doctor or with Choice In Dying. That will help you avoid writing your wishes in such a way that you accidentally preclude treatment you would want or permit treatment you don't want.In any event, discuss your plans and options with your family physician to make sure you understand the medical ramifications of your decisions and that the doctor understands and agrees with your wishes. Make sure, too, that he or she practices at hospitals that will uphold them. If not, you might want to change doctors. While most states have their own variation of a living will law, all states and the District of Columbia grant civil and criminal immunity to doctors who act in accordance with a living will. But they are not legally bound to.If there's an emergency, you may be attended by an unknown doctor who won't abide by your wishes written or otherwise. The following steps are worth trying, though they may be difficult in practice, especially in a critical care situation: Your family could bring in your family physician as a persuasive force, find another physician at the hospital who will agree to relieve the attending physician (the physician of record), or transfer you to another hospital.As with conferring power of attorney (discussed above), you should make a living will when you're of sound mind, that is, able to make decisions on your own behalf. Most states require two adult witnesses who aren't relatives be present at the time you sign the living will. In some states, people who stand to benefit from your death, such as heirs and insurance beneficiaries, are not allowed to be witnesses.Once you've written your living will, it's a good idea to review it every year or so. If it no longer reflects your wishes, you should change it or revoke it entirely by writing a new one. Make sure all your family members, other appropriate people and your doctors have copies, and ask your doctor to include a copy in your medical records.Click here to learn about help that is available for elders. Help Your Family Help YouIt's probably not enough just to prepare these legal expressions of your wishes. Take the time to personally discuss them with your family. A clear understanding of your intent will help everyone more easily honor your wishes. You can help eliminate any second guessing and avoid the interference of an uninformed or disapproving relative who could otherwise cause conflict and delay. You could even relay your instructions in a conversational way on videotape.If You Leave No InstructionsIn some states, if there is no clear and convincing proof of your desires, you must be kept on life support. In others, if you haven't written a living will and have not given someone durable health care power of attorney, the medical decisions will fall to your next of kin. He or she will have the legal right to tell doctors whether to pursue so called extraordinary measures to keep you alive.Which relative has seniority? The responsibility falls first on a guardian, if one has been appointed through the intervention of a family member or the state; if no guardian has been appointed, then it falls to a spouse; if no spouse, then to adult children; if none, then to a parent, if one is alive.While the decision rests with whoever ranks first in this chain of command, if someone lower down disagrees with the stand in's health care decision, any action must be postponed if possible until he or she can go to court and contest the decision. So, for example, if a desperately ill patient's adult children don't agree with her spouse about her care, they can ask a court to block the spouse's decision for the parent's medical care.In the other half of the states, the laws are vague regarding the next of kin's rights to make deathbed decisions. There is a presumption that they have the right, but an attending physician is not bound to abide by their decision. If the doctor does not accede to the next of kin's wishes, however, then the spouse or adult children may have to find another doctor or go to court.For more information on your state's law, call Choice In Dying (click here for their number). For More Information
Choice In Dying (formerly the Society for the Right to Die; 200 Varick St., 10th Floor, New York, NY 10014 4810; 800 989 9455, 212 366 5540). This non profit organization works for the right of patients to make their own medical decisions at the end of life and provides information on the issues surrounding terminal care. Call to receive free, state specific documents with which to write an advance directive and durable health care power of attorney.
The Hemlock Society (P.O. Box 11830, Eugene, OR 97440; 800 247 7421). Provides information and support to terminally ill patients regarding voluntary euthanasia.Help for Elders
National Association of Area Agencies on Aging (1112 16th St., N.W., Suite 100, Washington, DC 20036; 800 677 1116). The association's Eldercare Locator service can direct you to the closest agency on aging. It will also provide information on services ranging from legal assistance and housing options to adult day care and home health services.
National Academy of Elder Law Attorneys (1604 N. Country Club Rd., Tucson, AZ 85716; 602 881 4005). The academy can provide a free copy of Questions and Answers When Looking for an Elder Law Attorney. The organization won't give direct referrals to attorneys, but it sells its membership directory for $25.
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BY SIGNING ON TO THIS BLOG AND TO THE WEB SITE THE USER AGREES THAT THIS ACTION DOES NOT CONSTITUTE A LEGAL RELATIONSHIP BEING ESTABLISHED NOR SHOULD IT BE CONSTRUED AS LEGAL ADVICE FOR A SPECIFIC CASE. THE USER ACKNOWLEDGES THEY ARE FREE TO CONSULT WITH AN ATTORNEY OF THEIR CHOICE.
JOE FLORES, ATTORNEY AT LAW
FLORES LAW FIRM: EQUAL JUSTICE FOR ALL.
BY SIGNING ON TO THIS BLOG AND TO THE WEB SITE THE USER AGREES THAT THIS ACTION DOES NOT CONSTITUTE A LEGAL RELATIONSHIP BEING ESTABLISHED NOR SHOULD IT BE CONSTRUED AS LEGAL ADVICE FOR A SPECIFIC CASE. THE USER ACKNOWLEDGES THEY ARE FREE TO CONSULT WITH AN ATTORNEY OF THEIR CHOICE.
JOE FLORES, ATTORNEY AT LAW
Sunday, January 20, 2008
Harvest of Redemption by Fellow Texas Attorney Javier Chapa
Independent Film Producter/Actor/Director has released an awesome film. I recommend that everyone have a look. The film received international critical acclaim and is one of several projects for Javier who's talent will be even more self-evident in the future. Good luck Javier!
http://www.shortfilmtexas.com/2008/rio-grande-valley-film-harvest-of-redemption-gets-blockbuster-release/
http://www.shortfilmtexas.com/2008/rio-grande-valley-film-harvest-of-redemption-gets-blockbuster-release/
STOP HEALTH CARE FRAUD NOW!
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YouTube - HEALTH CARE FRAUD: WWW.FLORESLAWFIRM.COM
Floreslawfirm.com MESSAGE:Millions of Dollars are lost to health care fraud every year. Call the Law Offices of Joe Flores at 1-888-259-5721 or 361-887-8670...www.youtube.com/watch?v=jlyvVDESQjs - 63k - Cached
YouTube - HEALTH CARE FRAUD: WWW.FLORESLAWFIRM.COM
Floreslawfirm.com MESSAGE:Millions of Dollars are lost to health care fraud every year. Call the Law Offices of Joe Flores at 1-888-259-5721 or 361-887-8670...www.youtube.com/watch?v=jlyvVDESQjs - 63k - Cached
South Texas Crossfire
Our firm also has a political and legal show entitled South Texas Crossfire.com which airs throughout South Texas and on the web: www.southtexascrossfire.com. Tune in also on youtube with search terms south texas crossfire, joe flores or juan reyna.
Welcome to the Flores Law Firm
Welcome to the Flores Law Firm. The web blog is yet another way to the firm to help individuals who may need our help.
You may also visit us at www.floreslawfirm.com or call us at 361.887.8670 or email me directly at joe@floreslawfirm.com.
Thank you.
Joe Flores, RN,MSN,JD
Trial Attorney and Nurse Practitioner
You may also visit us at www.floreslawfirm.com or call us at 361.887.8670 or email me directly at joe@floreslawfirm.com.
Thank you.
Joe Flores, RN,MSN,JD
Trial Attorney and Nurse Practitioner
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