How an Advance Medical Directive works in practice? I will be signing a DPOA and Advance Medical Directive in a few days, but I live in a different state than the person those documents are for. If that person becomes incapacitated or is deemed unfit to make their own decisions, will I be required to be physically present (for example, to sign something) to make those decisions if called upon? I live in Washington State, the person I am signing these documents for is in California. Originally posted in Medical, I was told this question was better suited for Law. It is possible that there is not enough overlap between the two SE sites to arrive at an answer to this question, which is also an acceptable answer. If that's the case if anyone knows a plausible next step in answering this I'd appreciate it.
If that person becomes incapacitated or is deemed unfit to make their own decisions, will I be required to be physically present (for example, to sign something) to make those decisions if called upon? While it is customary for someone making decisions as weighty as removal of life support, to come to the hospital or care facility in person and discuss the issues with treating physicians, it isn't required. When you are physically there it is easier for you to personally assess the patient's condition rather than just taking someone else's word for it, and you have more informal access to everything that is going on in terms of people coming in and out of the patient's room, providers you wouldn't have known to speak to initiating conversations with you (e.g. there is typically an ER nurse for each shift, several residents doing rounds checking on a patient, and often also an outside specialist doctor involved in the treatment team). It is also usually easy when you are physically in a hospital to locate someone knowledgable and familiar with the kinds of issues you are facing at the moment to provide spiritual and religious guidance if you feel this would help you make your decision, while your neighborhood clergy person may not have a good understanding of these issues since they don't come up as often for someone is doesn't frequently spend time around people being treated in hospitals or hospices. And, this kind of pastoral counseling requires not just religious knowledge but an understanding of the options that are being presented through the lens of what is religiously and morally important about the differences between the different options. When I was an attorney for a hospital handling these issues for the hospital, we would have been willing to work with an out of state medical power of attorney agent without their physical presence. But, the fact that this was deep in the Rocky Mountains far from other urban areas (i.e. Grand Junction, Colorado) may have influenced a willingness to be flexible since it would often take a lot of time and money for someone to arrive in person. Also, while the medical power of attorney gives a specific person authority to act, an advanced medical directive is simply a document that goes into a patient's medical record that advises treating providers of the patient's intent and doesn't actually need next of kin approval or a medical power of attorney agent's say so to implement, although better practice is to seek that consent first in case there are any reasons why that advanced medical directive might have been procured improperly from someone lacking capacity or subsequently revoked. There usually will be forms for a medical power of attorney agent to sign, not authorizing a particular medical procedure, but authorizing treatment in general and providing personal and financial information about the patient in connection with admitting that person. But, these days, hospitals are relatively comfortable with handling that paperwork via fax or scanned copies sent via email, and some of the more flexible hospitals will even accept photos of signed documents sent via text message.
(I am not your lawyer. I am not here to help you. If you are reading this because someone has died, please stop and instead read the Scottish Courts and Tribunals guide to dealing with a deceased's estate in Scotland, or contact a solicitor.) Yes, in general. Section 1 of the Wills Act 1963, which is in force in Scotland, specifies that "[a] will shall be treated as properly executed if its execution conformed to the internal law in force in the territory where it was executed." Furthermore, Section 4 states that "[t]he construction of a will shall not be altered by reason of any change in the testator’s domicile after the execution of the will." "Construction" here refers to interpreting the language and effect of the will. So if the will was validly executed in England, it should also be in force in Scotland, and a Scottish court will give it the same meaning it would have had under English law. Furthermore, the same rule of validity seems to apply in both England and Scotland: Wills Act 1837 section 9. There may be other Scottish laws affecting the disposition of the estate that differ from English law. Relevant statutes include Succession (Scotland) Act 1964, section 21A, which seems consistent with Wills Act 1963. (I am trained in U.S. rather than English or Scottish law; I'm trusting the accuracy of the UK's excellent online legislation archive for the proposition that the statutes cited are in force in Scotland. I haven't checked the case law for contrary interpretations.)
If you can be revived, you are not legally dead. To be declared dead you must be in cardio-pulmonary failure and have all attempts at resuscitation cease or be brain dead - no one has ever recovered from these conditions. Notwithstanding, if you are declared legally dead and show up alive, that declaration can be nullified i.e. you were never dead.
The law in Washington, RCW 70.245, redined "terminal illness" as an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months. California law and Hawaii law say the same thing In Oregon, under ORS 127.505, the relevant term is "terminal condition", defines as a health condition in which death is imminent irrespective of treatment, and where the application of life-sustaining procedures or the artificial administration of nutrition and hydration serves only to postpone the moment of death of the principal. The law of The Netherlands is less restrictive, and does not involve "terminal" conditions. The most relevant condition from article 2 is that there must be a finding that "the patient's suffering is unbearable with no prospect of improvement" (plus, there are informed consent and a second opinion standards to be met). The Canadian law in §241.2 requires that "they have a grievous and irremediable medical condition". That means, specifically, that (a) they have a serious and incurable illness, disease or disability; (b) they are in an advanced state of irreversible decline in capability; (c) that illness, disease or disability or that state of decline causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable; and (d) their natural death has become reasonably foreseeable, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time that they have remaining. Simply having been exposed to a virus, or even contracting the disease AIDS, does not qualify under the law. At later points in the progression of the diseases, it could – depending on jurisdiction.
There aren't any specific laws or regulations about medical charges. Instead, this is a matter of general contract law, where you have to agree. You have to consent to be treated, and a signature is taken to be evidence of consent. The law does not say that they have to ask permission for absolutely everything they do, the action just as to be in accordance with an accepted standard of medical practice among members of the medical profession with similar training and experience in the same or similar medical community as that of the person treating, examining, or operating on the patient for whom the consent is obtained This law insulates doctors from getting sued. In a situation where treatment is provided against a patient's instructions, you may have a cause of action for e.g. battery. In general, a doctor can't poke you, draw blood, make "offensive contact" etc. without consent, and consenting to one procedure does not "open the floodgates" of consent for any othre procedure. Of course, if the procedure was not performed, you obviously are not liable for the cost (and they are not liable for a non-occurring battery). This may in fact constitute gross negligence. During trial, the primary issue is likely to be whether there is proof that the procedure was expressly rejected. The doctor would probably provide the consent form, and that form may or may not indicate that the test would be conducted. It would not be surprising if the patient never saw an actual form and instead just electro-signed, having been told that this is authorization to treat. Corroborating witnesses would be helpful. From a practical perspective, especially if the billing department is being recalcitrant, this is probably a matter best handled by an attorney who would start with a formal letter summarizing the consequences of unauthorized medical treatment.
You don't specify what country's law you're interested in, but as you mention precedent, I'll assume you're interested in common-law jurisdictions such as the United States. The short answer is: you won't find any successful lawsuits such as you describe, at least not without some significant additional facts. In order to be subject to liability, a person needs to commit a breach of some duty. In a civil suit, this needs to be a duty to the plaintiff. In order for it to be actionable for the doctor to not answer the phone, the doctor would have to have somehow assumed a duty to answer the phone at that particular time. Giving someone your phone number is not, in and of itself, a promise that you will never take a shower, or go to a movie, or let your battery run down, or for any other reason be unwilling or unable to answer your phone at a moment's notice. In addition, the patient would have to demonstrate that the doctor, by failing to answer the phone, caused some sort of harm. If the patient is having a medical emergency of some sort, the doctor's advice will almost certainly be: "Hang up and dial 911." This is something the patient can do without the doctor's help. Without some more significant and compelling facts, no court is going to impose a duty on a doctor to sit by the phone waiting for a patient's call.
One approach is to direct their attention to this publication from the NY Dept. of Health. It says "Physicians and hospitals are required by state law to maintain patient records for at least six years from the date of the patient's last visit". There is also a PDF printout which you can hand to them. If they still absolutely refuse, the publication explains about the appeals process and the consequence to the doctor, but it also provides some "rationalizations" that the staff-person might invoke (for example "Yes, but we charge for copying, I thought you meant for free" – they can charge up to 75 cents per page). There is no legal basis for their 2-year conclusion.
There is no state that requires you to show ID to obtain medical care. To the extent that this is done it is done at the behest of whoever is paying for the care to determine that you are someone who is authorized to benefit from this payment, and not an imposter, or as a matter of policy of the doctor. (An exception to this general rule applies when one wants to pick up a prescription for a controlled substance or a Sudafed product, where you must indeed show ID to show that your name matches a prescription or to insure that the right name is entered into the Sudafed database.) It might be more convenient for the doctor in terms of collection of bad debt, insurance policy claims (where an insurance card would normally be required, at least), protection against fraud claims from an insurer, and medical record keeping to have a name, so a doctor might make it a policy to require ID, but it is not required by law (except where a government benefit provider like Medicaid or Medicare is involved and has a regulation requiring it). For example, in the Las Vegas shooting, where there wasn't time to process paperwork, hospital triage officials simply assigned an alias to every incoming patient and wrote it in marker on their body to keep the medical records straight, and to allow that alias to track medical costs to be billed when the time came to get the proper intake paperwork filled out and the file sent to the accounting department. There are also other circumstances that do not involve emergency treatment (e.g. STD testing, methadone treatment at free clinics, and clinical trials) where an alias rather than a true name is sometimes used to keep track of patients.