By now we're all aware of the health outcomes of COVID-19, so it's a good idea to make sure you have an up-to-date Health Care Power of Attorney and Directive to Physicians.

By now we’re all well aware of the health outcomes that may result from COVID-19: life-threatening respiratory conditions, extended hospitalization, and the chaos of trying to get medical care from a strained health care system. Given the dangers of this pandemic, it’s wise to make sure you have up-to-date health care directives—that is, a Directive to Physicians (commonly called a "Living Will") and a Health Care Power of Attorney.

At minimum, your preparations should include these basic documents that describe your wishes for medical care. Some states (like Idaho) combine a Living will and a Health Care Power of Attorney into a single form.

A Living Will is your written instruction to your physicians of the type of treatments you do or don’t want to receive if you become so ill that you can’t speak for yourself.

A Health Care Power of Attorney names a trusted person to be your health care agent. If you are unable to communicate your own wishes, your agent will communicate with your doctors for you.

If you already have these documents but haven’t laid eyes on them for a few years, now’s a good time to make sure they still match your circumstances and wishes. For example, do you still want the health care agent you named? Has your health changed in ways that might affect your instructions? Are your values still the same?

Even if your wishes haven’t changed, if it’s been five or more years since you made your document, you may want to draft a new one. The health care providers tasked with following your instructions will be more confident doing so if the form was made within the past few years; that leaves less room for doubt that the form reflects what you would want today.

Finally, consider whether enough people know about your advance directives. At minimum, be sure your health care agent has a copy. You may also want to send a copy to the doctors and medical facilities in which you would be most likely to receive treatment.

Any comprehensive advance directive form should cover what you need at this time, though there are a few important issues to consider in light of the COVID-19 crisis.

Make sure your health care agent can communicate with doctors. Most advance directive forms let you give your health care agent broad authority to communicate with your health care providers. Though in-person conversations are common, there’s no reason your agent couldn’t communicate with doctors over the phone or by email in situations requiring physical distance. To make this extra clear, however, you could amend your document to explicitly say that it’s okay for your agent to communicate with your health care providers by phone, email, video conferencing, or similar methods.

In the most severe cases of COVID-19, intubation—providing oxygen to a patient through a tube attached to a ventilator—may be necessary. But what happens if you’ve made an advance directive stating that you don’t want to be intubated? In that case, technically speaking, doctors shouldn’t withhold a ventilator if you have COVID-19 unless they believe you have no hope of recovering. That’s because health care instructions like these become legally effective only if doctors determine you have a terminal condition—one that can’t be cured or reversed by treatment.

That said, it’s difficult to know exactly how a traditional advance directive form will be interpreted or implemented during a pandemic like this one. Hour by hour, medical professionals are making difficult and uncertain choices for patients in severe respiratory distress. Even if doctors know a patient has made an advance directive, they may struggle to assess whether or not that patient can recover or whether the patient would want to be put through extensive and invasive procedures for a slim chance at regaining their previous quality of life.

Keeping this in mind, it’s wise to take a couple of steps regarding your health care instructions: First, review your advance directive’s language with the coronavirus in mind. Be sure you understand what your document says and that it accurately reflects your wishes. Supplement your instructions as needed.

For example, if you feel concerned that you will contract COVID-19 and doctors would withhold a ventilator when you want one—perhaps in the scenario where there aren’t enough ventilators to go around—add a note to your document saying so. On the other hand, if you don’t want doctors to intubate you or keep you on life support if they feel you are unlikely to recover or that your quality of life would be severely compromised by the virus, say so explicitly.

Second, but perhaps even more important, talk to your health care agent and those closest to you about your wishes. This may be difficult to do, but it’s essential.

If you have questions about Directives to Physicians and Health Care Powers of Attorney, feel free to give us a call at 253.858.5434 to see how we can be of service. We represent clients throughout Washington and Idaho and are available to meet in person, by phone, or via video conference.