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VanNess & VanNess, P.A.
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One of the single greatest benefits of executing a comprehensive estate plan is that it enables a person to set forth their exact wishes regarding both medical treatment and end-of-life care. Here in Florida, the primary mechanisms through which this can be accomplished are a living will and a health care surrogate designation.

To recap, a living will is a legally binding document setting forth in great detail the type of medical care that you either do or do not want performed in the event of your incapacity. Conversely, a health care surrogate designation -- sometimes referred to as a medical power of attorney -- is a legally binding document that enables you to appoint a trusted person to make medical decisions on your behalf in the event of your incapacity.

Interestingly, a recent study by researchers from Johns Hopkins School of Medicine set out to examine the extent to which cancer patients here in the U.S. have adopted advanced health care planning -- meaning the execution of at least one health care directive -- from 2000 to 2012.

The study, published in the medical journal JAMA Oncology, determined that the number of cancer patients undertaking at least one type of advanced care planning (living will, power of attorney or end-of-life discussion, etc.) sat at 81 percent in 2012.

Breaking the numbers down further, they determined that while the number of cancer patients executing a medical power of attorney rose from 52 percent in 2000 to 74 percent in 2012, the number of cancer patients executing living wills remained static.

While this might not seem especially notable, consider that the researchers also found that the number of cancer patients who received "all possible care" prior to their deaths rose from just seven percent to 58 percent during this timeframe, and that the majority of cases relating to withholding or limiting care near the end of life were only traceable to living wills.   

What this likely shows, say the researchers, is that those entrusted to make medical decisions on behalf of these cancer patients most likely had difficulty with this important duty.

"Without written or verbal direction, surrogate decision makers may struggle to make care decisions consistent with patient preferences," reads the study. "As such, policy and health system initiatives that support wider adoption of clinician-patient discussions of end-of-life care preferences are essential."

Indeed, they argue that those who are facing a serious illness and choose to execute only a power of attorney should strongly consider holding an end-of-life discussion with both their surrogate and their medical professional present.

All this is not to say that a health care surrogate designation is somehow not a valuable estate planning tool. Rather, it merely underscores the importance of all parties making sure that they are on the same page, such that there is a clear course of action to be taken should the unimaginable occur.

If you have questions about living wills, health care surrogate designations or other estate planning documents, consider speaking with an experienced legal professional as soon as possible. 

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