Do you have the power of attorney over another person's healthcare decisions?

If she becomes so sick that she can't make informed decisions, the medical people will ask you what to do. Should extraordinary measures be taken to resuscitate? Should a ventilator tube be inserted when natural breathing fails? Or, if the Grim Reaper is standing at the door, should the medical team merely manage pain and allow nature to take its course with dignity?

On my late father's Durable Power of Attorney for Healthcare, he'd added a small handwritten Post-it note: "Please think twice before pulling the plug."

Warren Buffett Wrote A Similar Note.
So many folks over the years — increasingly as Mr. Buffett ages — have asked him what happens to his Berkshire Hathaway when he dies. His answer is that the next steps are clearly outlined on one page in an envelope in the center drawer of this desk. And, he says, on the outside of the envelope he's written the first step: "Double check to make sure I'm dead."

(You might enjoy his many fabulous letters to the fortunate shareholders of Berkshire Hathaway.)

Have you taken the right steps? Do you have the proper documents in order: Will, Living Will, Durable Power of Attorney for Healthcare, and Ethical Will? If you haven't any of them, you might as well write any one of them today. Having one is better than none, according to someone who has never been to law school.

But, wait. Let me make this more complicated.

Here's A Fifth Document You Might Consider
With your permission, I'd like to suggest we prepare for another awkwardness in the hospital. I propose we each have a Durable Power of Attorney for Communications.

Here's why:

Louise becomes suddenly sick. Imagine: a mild stroke causes aphasia, a loss of speech.

You are her next of kin (or closest friend) and have her Durable Power of Attorney for Healthcare. Immediately, at the hospital, you are the person who sits by her bedside. She can't communicate to you. You try to answer the medical team's questions, best you can.

Within hours — whether you tell people or not — the world starts to know that Louise has gone missing and people start asking, "What is going on?"

What is your ethical obligation? What may you reveal about Louise's condition? Every time you open your mouth, there is tension:

  • In healthcare, especially during early critical moments and days, you probably don't know what's happening. You might hear a doctor say "X," but you don't fully (or even half) understand what "X" means — and "X" might change during the next hour. Do you tell someone who calls "X"?
  • Louise has her dignity. Perhaps she doesn't want friends to know that she is stricken. After all, she might be well within a couple of days. Do you protect Louise by concealing her condition?
  • The world is a communicopia, with so much communication moving so quickly and so far. You will soon be swamped with requests for information. How can you keep up with the calls?
  • The list of callers increases. You try to keep track of what you have told each. How can you keep your message consistent and up to date?
  • And, of course, you are under a great deal of stress. Louise is the sick one, but she's staring at you and you have to do something. But what?

Two Challenges
You wonder:

  • Am I authorized to communicate on behalf of Louise?
  • Am I allowed to communicate in any way, through the communications channels of my choice?

That's why I think we might all edit (to our individual liking and wishes) and then sign the following document, filing it with our Living Will and Durable Power of Attorney for Healthcare.

(I don't know why "durable" is used. It could be just be Power of Attorney… But it is such a trustworthy word, so — well — durable, that I'm using it in the name of the new document, too.)

Durable Power Of Attorney for Communications
[Here's mine:]

I, Artie Isaac, being of sound mind and body, and being connected to so many wonderful caring people, do authorize my family and best friends to communicate on my behalf should I become unable to do so.

I ask that they inform people about my condition and permit them to do so via any communication resource of their choosing, including but not limited to telephone, email, or blog, including branded channels, such as Facebook, Twitter or CaringBridge.

I recognize that their communication will be imperfect, but I appreciate their best efforts and indemnify them.

However, I do ask that they — and those that my relay details of my condition through a viral network of friends and acquaintances — limit their communication ethically. To test the ethics of their words, I request that they ask three questions before speaking about me:

  • "Are the words I am about to speak true?"
  • "Are they kind?"
  • "Must I speak them?"

What Now?
I invite all smart people — especially anyone who has studied law — to weigh in with comments. (Please don't write me a side email. Please click on Comments at the bottom of this post. At the bottom of the comments there's a place for you to post a comment.)

Like the other powers of attorney, I hope you never need mine.