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The Health Care Directive

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Sandy Botkin

Co-founder at Taxbot
Sandy is a CPA, Tax Attorney, and former IRS trainer. He has authored many helpful books on the subject of taxes, including 7 Simple Ways to Legally Avoid Paying Taxes ( Click Here ), Lower Your Taxes: Big Time ( Click Here ), and Real Estate Tax Secrets of the Rich ( Click Here ).
Sandy Botkin
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Years ago, Terri Schiavo went into a coma that put her into an “irreversible vegetative state.” Her husband wanted all further costly attempts at keeping her alive ended. However, her parents wanted these attempts continued, which resulted in a huge court battle costing a fortune. Everyone lost in this case except the lawyers because there was no clear health care directive giving doctors the instructions to withhold treatment or resuscitation.

Here is another story: Maria had a health care directive. Thus, when she died from congestive heart failure, you would think that all would have ended peacefully. However, the doctors, contrary to her wishes, shocked her heart back to life and put her on a mechanical ventilator. Maria expressed her desire to be taken off the machine through a series of yes/no hand squeezes with her son, but the hospital persisted even though she had a health care directive asking NOT to be resuscitated. The reason for this was because the documents began, “if I am terminally ill..…” and the doctors said she had a slim chance of survival and thus her request not to be resuscitated was ignored.

Sadly, many people will unnecessarily endure deaths very different from what they desired. Here is how to increase the odds that your priorities will be honored when the end approaches.

1Make sure to have a health care directive accessible and filed with your local hospital. Give copies to family members. Unlike what happened to Maria, make sure your preferences are clear.

2Tell your loved one what you want… repeatedly. Do this on multiple occasions to ensure your words are remembered.

3Gauge your doctor’s willingness to respect your decision.You need to share your end of life priorities with your primary care doctor then ask for his or her feelings on the matter. Your doctor should voice respect for your priorities. If he does, ask them to add your advance directives to your medical file. If he or she dismisses the topic or expounds on their own philosophy, it might be time to look for a different doctor.

4Film yourself explaining your end of life preferences. Pictures can speak volumes. Look directly into the camera, such as the one on a smartphone, and calmly and clearly explain what’s most important to you in your life such as: being capable of thinking clearly enough to have a coherent conversation with my friends… living in my own home… enjoying meals with my family… reading and understanding the newspaper. etc. You will need to clearly note what you cannot live without and what you hope will be done if you can no longer do these things. Obviously, you need to let several trusted loved one know how to gain access to this video in your records when the time comes. I would even email copies of this video to them. I should note that this video won’t carry legal weight but can have a very real emotional weight. It is very difficult to ignore someone’s deeply held desires after looking into their eyes while they explain them.

5Make sure you really understand your medical situation: For example will your condition be treatable or curable. These are very different results. Thus, you need to ask what the likelihood of a cure will be and what the odds are of prolonging your life. You also need to ask what the reasonable goals of the treatment area.

6Sign up for hospice if you think your condition can be terminal. Hospice can make a patient as comfortable as possible with pain relief and other palliative treatment. Private insurance and Medicare usually covers Hospice treatment.

Following these tips should help avoid the problems experienced by those mentioned above and make your life and especially the lives of your family a LOT less taxing.

PLEASE share this to your friends and family. This may be one of the most important posts that I have made.


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Sandy Botkin

Sandy is a CPA, Tax Attorney, and former IRS trainer. He has authored many helpful books on the subject of taxes, including 7 Simple Ways to Legally Avoid Paying Taxes ( Click Here ), Lower Your Taxes: Big Time ( Click Here ), and Real Estate Tax Secrets of the Rich ( Click Here ).

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