If you were involved in a medical emergency and you could not express for yourself
what type of medical treatment you wanted (or did not want), would your loved
ones or the medical team taking care of you know what your wishes were? What if
you were away from your home. on a vacation and didn't happen to pack your
medical power of attorney or living will in your luggage?
I am sure you have heard the sad story regarding Terri Schaivo-the young woman in
Florida who was kept alive by artificial means while she remained in a
persistent vegetative state for years. Heart wrenching stories such as this
certainly highlight the fact that everyone, not just older members of the
population, needs to have a living will and a medical power of attorney. These
documents set forth the individuals' particular wishes concerning their medical
quality of life and their right to die.
On March 1, 2005, Arizona launched a quick-access online "Advanced Health Care
Directives Registry." This registry might change the course
of your life and spare you or your loved ones the agony of expensive, intrusive,
or undesired medical treatments by granting certain persons instant access to
copies of documents concerning your medical desires ... and the best part is
that it will not cost you a penny.
The importance of having health care directives.
As an estate planning attorney, many people come to my office
prepared to discuss issues regarding the transfer of their assets when they die.
Many do not expect that the conversation will turn in to a series of "what
if" questions about what they would want to have happen if they were brain
dead and hooked up on life support. I believe it is critically important that my
clients tell their loved ones what their wishes are concerning their medical
care in the event that they cannot act for themselves. Because of this, I draft
health care power of attorney instruments and living wills (sometimes called
"advanced directives" or "health care directives") as a
matter of course for my clients. I do not want any of them (or their families)
to be the subject of another Terri Schaivo-type story.
What to do with the executed directives.
Although signing an advanced directive is important, this executed document is virtually
of no value if it is not readily available to the people who will need to read
it and use it when "the time" comes. Keeping a living will or health
care power of attorney in a desk drawer or in a locked filing cabinet will not
prove helpful to medical personnel or loved ones in the event of a medical emergency. I used
to advise my clients to give copies of their advanced directives to their
doctors for placement in their medical files, but due to recent legislation, my
advice to them has changed somewhat. Now, in addition to telling my clients to
give copies of their directives to their doctors, I also encourage them to
register their living wills and medical power of attorney instruments with the
Arizona Secretary of State's office in the new "Health Care Directives
The Arizona Health Care Directives Registry-How Does It Work?
The registry works as follows: After a person executes his or her advanced health care directives,
he or she sends copies of the documents (along with a filing sheet that is found
on the Secretary of State's website located at www.azsos.gov
) to the Secretary of State's office (1700 West Washington -7"' floor,
Phoenix, Arizona 85007 Attn: Advance Directives Registry). The documents will be
scanned into the Secretary's system, and a printed record of the scanned
document will be sent back to the applicant for review. The person will also
receive a wallet sized card containing a file number and a confidential
password. The person will review, sign and return the printed record confirming
that the information contained is correct. Once the confirmation is received by
the Secretary of State's office, the file number and password on the wallet card
will be activated.
What about access to the registry and its security?
Secretary of State Jan Brewer highlighted that "Security and accuracy are two
important keys to the registry". Gene Palma, Director of Business Services
at the Secretary of State's office (the division which will oversee the
registry), added that "it is the applicant who has the personal
responsibility to be in charge of what goes on the system and who can access his
documents." Individuals can give their individual file numbers and
passwords to anyone they want to have access to their health care directives.
Such people might include their doctors, attorneys, agents, family members, or
trusted neighbors. When needed, these people enter the access code and password
in the registry's website, and obtain copies of the directives via the internet.
The hope is that instead of fumbling through a pile of papers trying to locate a
person's health care directives in the case of an emergency, the medical team or
family members will find the card in the person's wallet or purse and can obtain
copies of the person's documents immediately. One great feature of Arizona's
online registry is that people can access copies of their directives from the
Secretary of State's website (www.azsos.gov)
even if they are out of state when a medical emergency occurs.
In addition to giving people peace of mind that their health care directives will be
followed because they are easily accessible, Arizona's new registry is free to everyone
who wants to participate. What? No fee? How is that possible? The registry is privately
funded. When the details of the registry were discussed, private funders, such as Hospice
of the Valley, stepped up to the plate by pledging to assist in the funding of the registry.
Arizona is the first state in the nation to have a free, privately funded, advanced
directives registry. (North Carolina is currently the only state that has a registry,
however, a fee is charged to submit each document.) Certainly Arizona's registry will
be a model piece of legislation for the entire country.
Do yourself a favor: execute a living will and medical power of attorney today and
register them. Then advise your family and friends to do the same. When the time comes,
you (and they) will be thankful that you took the time to do so.
Denise E. McClain is an attorney in the Phoenix office of Quarles & Brady Streich
Lang LLP. She focuses her practice in the areas of estate planning and related family
legal matters. Ms. McClain can be reached at (602) 229-5485.