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Medical care planning makes decisions difficult

Sandra W. Reed

Nadine signed a medical power of attorney appointing her husband, Dave, to make medical decisions for her should she become incapacitated. She was conflicted about signing a medical directive. She had seen an aunt being kept alive for years in a vegetative state and she didn’t want that.

In contrast, a cousin had recovered after being in a coma for several months following an accident. If the cousin had been taken off life support, he wouldn’t be alive today.

What is a medical directive?

A medical directive tells doctors and family what health care an individual wants under certain conditions. An acceptable form is provided in Texas Health and Safety Code §166.033. However, a person may choose to include provisions other than those on the form.

Patient with terminal or irreversible disease

Among the choices available in the Texas medical guideline are treatment if the patient has a terminal illness that is expected to die within six months or an irreversible illness, is not able to care for himself or make decisions for himself or herself and is expected to die without life-sustaining treatment.

The guideline defines a “terminal condition” as “an incurable condition caused by injury, disease or illness which, in reasonable medical judgment, will result in death within six months, even with available life-sustaining treatment provided. in accordance with current medical standards. care.”

An “irreversible condition” is “a condition or disease that can be treated, but is never cured or eliminated, that renders a person unable to care for himself or make decisions for himself and which, without life sustaining treatment provided in accordance with prevailing standard of medical care, is fatal.

The signer may choose to have withheld all treatments, other than those necessary to maintain comfort or to be kept alive in this terminal state using available life sustaining treatments.

Nadine’s doctor pointed out that “life-sustaining treatment” includes life-sustaining drugs and artificial life support, such as mechanical breathing machines, kidney dialysis treatment, and hydration and nutrition. artificial, but does not include the administration of pain medication, the performance of a medical examination, a procedure or treatment to provide comfort or to relieve pain.

Nadine’s doctor mentioned examples of “irreversible diseases” such as advanced stages of dementia, diabetes, kidney disease, neurological disorders, terminal cancer and brain death. He also suggested Nadine read an article titled “Advanced Care Planning: Medical Issues to Consider” by Cheryl Arenella, MD, MDH, at

Medical care planning decisions are difficult

Obviously, making decisions in advance about the desired medical treatment is not easy. Advances in medical treatment or other factors may cause individuals to change their minds about a previous decision. Fortunately, a medical directive can be revoked at any time, as long as the manufacturer is mentally capable.

Sandra W. Reed practices elder law in Somervell County, which includes managing estate probate, drafting wills, trusts, powers of attorney, and deeds, as well as estate planning and Medicaid. She lives on beautiful Chalk Mountain and can be reached at 254.797.0211; 817.946.2809 or [email protected]


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