When you travel, you know to bring a passport — it is the only way to cross borders, and an important piece of identification. But it isn’t the only document you should have with you when you leave home. Three others could be matters of life or death.
1. Health Care Proxy
A health care proxy is a document that allows you to name the person you want to be able to make medical decisions for you if you can’t make them yourself. If you become unconscious, unable to speak, or incoherent, your health care proxy will step in and work with doctors to decide the best treatment.
For heterosexual married couples with the same last name, there is usually no question who has the authority to make medical decisions in this situation — doctors will automatically turn to the patient’s spouse. The situation is less clear for people who are not legally married, for heterosexual couples who are married but have different last names, and for gay couples, married or not. Doctors may not be willing to accept the authority of a life partner who doesn’t come in the traditional shape and packaging, and may not trust anyone to speak for a patient who is not romantically attached. Things can get even more confused if you are partnered but want a third party to make your health care decisions.
A health care proxy can clear things up and put the person you have chosen in charge.
Even if you have a health care proxy, things may not go the way you wish. Different jurisdictions have different laws, and in some the health care proxy document that passes muster in your state may not do the job. Then there is the question of the particular doctor or hospital that is caring for you. They may refuse to recognize your gay partner’s authority because of their own prejudice.
2. Marriage Certificate
If the person you have named as your health care proxy is your spouse, having your marriage certificate handy could help reinforce that person’s authority, especially with medical personnel who are nervous about relying on the health care proxy alone because of fears of legal liability. If your proxy wants less than the most aggressive treatment available, a doctor may fear liability for not providing the best care. Being able to prove that your proxy is also your spouse should help alleviate the doctor’s concerns.
3. Living Will
A living will is a document that specifies what kind of medical treatment you want if you become unable to make or express your decisions. In a health care proxy, you name someone to make decisions; in a living will, you state some of the decisions you want them to make. A living will is no substitute for a health care proxy because it cannot cover every possible situation. At best it can provide some guidelines and some hard-line rules for your health care proxy to follow.
One of those hard-line rules may be a do-not-resuscitate order, or DNR. A DNR tells health care professionals not to perform CPR if you stop breathing or your heart stops beating. It may be appropriate for people who are severely debilitated or terminally ill. In the absence of a DNR, CPR will be performed.
Like with a health care proxy, the power of a living will depends on the local laws and on the attitudes and institutional rules of the medical personnel and hospital treating you.
Blank forms to create health care proxies and living wills are available for free on the Internet, or you can hire a lawyer to help you customize the documents. Getting a marriage certificate is slightly more involved, but I’ll leave that up to you.
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