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Advanced Directives: What Are They and When Are They Enforceable?

Marlise Munoz, a 33 year old wife and mother of a 15 month old son, has been on life support in a Texas hospital since November, when she collapsed on her kitchen floor. Although doctors have declared Mrs. Munoz brain dead, and Mr. Munoz is emphatic that his wife never wanted to be kept on life support, the hospital cannot remove her due to a Texas law that requires pregnant women to be kept alive by artificial means until a fetus can be delivered. Texas is one of at least 31 states that place restrictions on doctors when removing life support in terminally ill women who are pregnant.

Mr. Munoz says he and his wife discussed end of life decisions since both are paramedics and saw many situations that made them think about what they would want if critically or terminally ill. Mr. Munoz insists that his wife was clear in her desire to never be kept alive by life-support.

But she did not have a living will. Even if she did, would she have thought to include a situation involving terminal illness and pregnancy? Would a living will regarding pregnancy in a person on life support trump the Texas law, or would the Texas law overrule the living will?

These questions all relate to the validity and enforceability of advance directives. Advance directives have detailed, state-specific requirements that must be met in order for the directive to be enforceable. Because advanced directives must meet certain requirements, it is advisable to consult with the Thomas Law firm when formulating your plan for care.

There are two types of advanced directives: (1) a living will which contains written directives to health care providers, and (2) a health care proxy, or "power of attorney" for health-care decision making, in which you designate a person who will be sympathetic to your desires in medical decision making.

It is a good idea to have both forms of advance directives since it is impossible to anticipate every circumstance that might arise--as the Munoz case illustrates. If in that case Mrs. Munoz had made a living will stating her desire to not be kept on life support, and had designated her husband her health care proxy with power of attorney to follow through with her decision, the family would have a much stronger position versus the Texas law.

Although end of life care is not pleasant to think about, it is something that people should have the right to determine and control. Advance directives give people this right if done properly. For more information, visit the Thomas Law Firm for a free consult.

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