An advance directive is a legal document, such as a living will, that allows consumers (declarants) to express their wishes about medical care. Such documents are created to provide guidance and direction to caregivers, and they only take effect if the declarant is unable to participate effectively in his or her own medical decision-making.
Recent changes in Connecticut law have expanded and clarified the scope of the living will and allowed for the appointment of a health care representative to act as a surrogate decision-maker should consumers become unable to manage their own health care.
Previously, Connecticut law permitted the creation of a living will that documented the declarant’s wishes to receive or not receive artificial methods of life support, such as the use of a respirator, intravenous nutrition and hydration, or artificial resuscitation, in cases where declarants became unable to make or communicate these decisions themselves, because they were in a terminal condition and near death, or because they were in a persistent vegetative state with no hope for recovery.
Under the new law, consumers can express their wishes in advance for medical care other than life support, should they become unable to participate in decisions about their treatment.
Under both the old law and the new law, a living will can not be interpreted to deny a person comfort care, such as pain management and non-intravenous means of nutrition and hydration support.
The new law does not invalidate any previously completed living wills. In fact, it provides for legal recognition of living will documents from other states, when they have been properly created in accordance with the laws of the other state, and when they do not conflict with Connecticut law.
The new law, effective October 1, 2006, lets consumers appoint a health care representative to be a surrogate decision-maker for them, should they become unable to perform this function independently, as determined by the attending physician. Previously, consumers could appoint a health care agent or a power of attorney for health care. The new regime combines these advance directives into a single role known as the health care representative. The declarant can authorize the representative to, among other things, consent to or refuse care; employ or contract with service providers and caregivers; have access to health records; admit or release the declarant from medical facilities; and to provide or withdraw life support systems. If consumers’ specific wishes are not known, the statute authorizes the representative to act in their best interests.
Because of the power of this role, and the vulnerability of the patient, the person appointed to be a health care representative must be someone the declarant trusts completely. Consumers cannot name a medical care provider to be the representative.
The appointment of a health care representative must be in writing, signed by the declarant, and signed by two witnesses. It is a good idea to have the document notarized. Once a representative is appointed, revocation also requires a signed document, with two witnesses. A living will, by contrast, may be revoked without a signed writing.
If you want your voice heard regarding your health care in the event that you become unable to communicate effectively your wishes to those responsible for your care, it makes sense now to take time to think about your preferences and to document them in these two advance directives: a living will and the appointment of a health care representative.
