Kirk U.S. Army Health Clinic hosted a second annual National Healthcare Decisions Day event April 16 to build growing awareness of advanced care planning and to remind people of the importance of making their healthcare wishes known to loved ones and their care providers.

Jason Barocas, Esq., and Tanya Adams, a paralegal, who both work for the garrison's Office of the Staff Judge Advocate, were available at the event to help answer legal questions concerning Advanced Medical Directives.

Barocas said that although turnout was low, he hopes that having a day designated for healthcare decisions will cause more people to understand the importance of having an advance directive and to take action.

"People want to think they are invincible, and death is not something people want to think or talk about," Barocas said. "But it is important for responsible adults to have a plan in writing, in the form of an advanced directive, so that they can receive the healthcare that they desire if they cannot speak for themselves."

Barocas added that uncertainty about patient's wishes can lead to tragic results, as seen in the Terri Schiavo case which gained national attention in 2005. Schiavo had been sustained by artificial hydration and nutrition through a feeding tube for 15 years, while her husband, Michael Schiavo, was locked in a very public legal struggle with her parents and siblings about whether such treatment should be continued or stopped.

"The simple act of creating an advance directive can turn out to be an incredible gift for loved ones in the event of an accident or severe illness," said Nathan Kottkamp, chairman of the National Healthcare Decision Day initiative.

Having an Advanced Medical Directive, which is a legally binding document, can save Family and loved ones from expensive medical costs and grief when there is no hope of revival.
According to the National Healthcare Decisions Day Web site, an Advanced Medical Directive comes in two main forms:

A Health Care Power of Attorney, (or "proxy" or "agent" or "surrogate") documents the person selected to voice a patient's healthcare decision if the patient cannot speak for his or herself.

A Living Will documents what kinds of medical treatments the patient would or would not want at the end of their life.

Barocas added that Maryland law requires the signature of the person making the living will and two witnesses. If an agent is appointed to carry out the healthcare wishes, the agent may not also be a witness.

Barocas said that living wills can be revised or revoked at any time. For example, a person might decide to change their living will to make their spouse the agent when they get married.

Barocas advised giving the original copy of the living will to the agent, keeping it in a designated spot, like a fireproof safe, and providing copies to Family members and doctors and anyone else who might have a say in the patient's healthcare. A notification card should also be placed in the patient's wallet letting first responders and others know whether or not they have these documents and whom to contact in case of an emergency.

Debbie Dodsworth, KUSAHC patient advocate, said that the National Healthcare Decisions Day is a good opportunity to educate patients about important legal matters concerning their healthcare.

"While the emphasis was on advance directives, there are other legal decisions that have to be made concerning medical care," Dodsworth said. "This was an opportunity for people to learn about legal matters that are part of all our lives, especially now."

Dodsworth continued by saying that parents need to put the medical decisions that they make for their children in writing when they leave the child with a guardian.

"At Kirk, we have had situations when children are brought in by individuals without a Medical Power of Attorney or signed notarized letter that they are the guardian for the child in the parents' absence," she said. "Federal law defaults to Maryland law that it is a requirement that the adult have the necessary documentation in order for our providers to give medical care for routine matters like a cold. While Soldiers will make provisions when they go overseas, many do not for times when they are going TDY [temporary duty] state-side and leave the children with a guardian, like a grandparent, for example."

Barocas said that Soldiers and their Families can receive free legal assistance regarding their advance directive on Wednesdays with an appointment, by calling 410-278-1583.

Barocas added that legal assistance is not necessary to have an Advance Medical Directive, as it is a relatively easy process.

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