COVID-19 merges medical and legal issues

By Leisa Boley Hellwarth, a dairy farmer and attorney near Celina

Doctors shouldn’t practice law. Lawyers shouldn’t practice medicine. And politicians shouldn’t practice medicine either, but I digress. Some of the most practical and timely legal information I’ve read recently came from a physician practicing in a COVID-19 Unit in Detroit, who shared what she wished her patients had completed prior to their coronavirus diagnosis, advance directives. These legal documents are a set of instructions someone prepares in advance of ill health that determines his healthcare wishes. End of life is a topic none of us likes to contemplate, but according to the doc, not dealing with the inevitable can make the inevitable even more problematic and painful for the patient and the family.

She shared the anguish of the next of kin of a 30-year old patient whose body was unable to fight the coronavirus. He had not executed any legal documents nor had he ever discussed the issues with his family. As a result, his parents disagreed. The father wanted palliative care while the mother pushed for every possible treatment. Sadly, the son died, and the parents were mourning while angry with each other.

Statistics indicate that only about one-third of all Americans have authorized advance directives. In Ohio, living wills, durable power of attorney, organ donation and Do Not Resuscitate Orders are advance directives that are authorized by state law.

The living will is the original advance directive. This document lets people state their wishes for end-of-life medical care, in case they become unable to communicate their decisions. Under Ohio law, a living will declaration is applicable only to individuals in a terminal condition or a permanently unconscious state. If you wish to direct medical treatment in other circumstances, you should prepare a health care power of attorney. If you are in a terminal condition or a permanently unconscious state, the living will declaration controls over a health care power of attorney.

A health care power of attorney is a legal document that empowers a specific individual to speak with others and make decisions on your behalf concerning your medical condition, treatment and care. It is important to select someone you have the utmost trust in as your health care power of attorney. This individual may be charged with making life-and-death decisions on your behalf.

In Ohio, organ donation registration is conducted by the Ohio Bureau of Motor Vehicles (BMV) when renewing a driver license or state identification card. You may also register online through the BMV website or through a paper form.

Ohio also recognizes Do Not Resuscitate “DNR” Orders, which help you and your physician effectively plan your health care for the end of life. Unlike the other advance directives, the DNR Order is a medical order that a physician must write.

We are all different, with varying ideas on what is appropriate for end of life care. These legal documents can be written to precisely reflect your wishes. And the documents can be updated easily, in the event you change your mind.

Take these documents with you when you require hospitalization or when you travel away from your home area. Most hospitals inquire if you have advance directives at the time you register.

You may seek the advice of a lawyer when completing advance directives. Legal counsel will review the documents with you and insure the advance directives match your wishes and are legally enforceable. Members of the public can obtain copies of Ohio’s living will and durable power of attorney for healthcare forms from Leading Age Ohio’s website at www.midwestcarealliance.org.

I recently spoke with a local physician who shared a fascinating coronavirus story. He was called by a city hospital treating one of his patients with COVID-19, who was on a ventilator and doing poorly. The patient was older and had a weakened immune system. The urban medical center inquired if the local doctor had any advance directives from the patient. The local doctor did not. He learned weeks later that the family requested palliative measures and placed the patient in hospice care. And then the patient recovered!

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