Is the Health Care Power of Attorney Sufficient on Its Own?

General Reference (not clearly pro or con)
Karen Krebsbach, Attorney, wrote in her June 1, 2002 article, "Living Will or Health-Care Proxy? Having Both May Create Confusion," that appeared in Bank Investment Marketing:

"Conventional wisdom among estate planners is that clients should have both a living will and a health-care proxy, but are both really necessary? Yes says one attorney. Nope, says another. Moreover, a real complication can arise if the two documents conflict and crash head-on into confusion for a family, a likely outcome if they're not crafted in unison."

June 1, 2002 - Karen Krebsbach 

PRO (yes)

Wesley Smith, JD, Anti-Euthanasia Activist, wrote in his 1997 book Forced Exit:

"The Durable Power of Attorney for Health Care (DPAHC) appoints an 'attorney in fact' to be the patient's health-care decision maker should he or she become incapacitated... The DPAHC also permits people to opt in favor of life-prolonging care, an option often unavailable in the language of living wills...

In a world of assembly-line medicine where many patients have little interaction with their doctors, isn't it better to eschew a doctor-empowering living will in favor a patient-empowering durable power of attorney? It's not as catchy a name but it is a much better document, one that may make the difference between suffering a premature death and receiving personal health-care decision making, which everyone deserves."

1997 - Wesley J. Smith, JD 

Rita Marker, JD, Executive Director of the International Task Force on Euthanasia and Assisted Suicide, wrote in her Apr. 13, 2005 article "Be Prepared" that appeared in the National Review Online:

"A living will is the oldest type of advance directive... But, since the document is so vague and the attending physician may be unfamiliar with the signer's views and values, the document could be interpreted by the physician in a manner that was not intended by the signer...

The most protective and the most flexible type of advance directive is the 'Durable Power of Attorney for Helath Care'...

Having a carefully drafted Durable Power of Attorney for Health Care is vital for every adult--young or old, healthy or sick,disabled or able-bodied. That is the only way to be assured that someone who has your best interests in mind will be making your medical decisions if you are ever unable to make those decisions for yourself."

Apr. 13, 2005 - Rita Marker, JD 

Focus on the Family wrote in a section of their website entitled "Advance Medical Directives," that was last updated on Dec. 6, 2005:

"The 'Living Will' Declaration is discouraged and the Durable Power of Attorney for Health Care is encouraged for the following reasons:

...Durable Power of Attorney for Health Care:

Names a person who will be your health care agent to make your medical decisions in any crisis, regardless of prognosis

Gives decision-making authority to a loved one who knows your wishes and has discussed such decisions with you

Legally clarifies your health care agent (as well as secondary agent if primary is unable to serve) instead of leaving such determination up to state law

Generally exempts doctors from liability if following directions from your health care agent

Defers all decisions to your health care agent."

Dec. 6, 2005 - Focus on the Family 

CON (no)

The National Hospice and Palliative Care Organization wrote in its 2005 pamphlet, "Questions and Answers: Advance Directive and End-of-Life Decisions":

"You can best protect your treatment wishes by appointing a healthcare agent and preparing a living will. Each offers something the other does not...

Benefits of having a living will: If your agent must decide whether medical treatment should be withheld or withdrawn to permit you to die, your living will can reassure your agent that he or she is following your wishes. Further, if the person you appointed as agent is unavailable or unwilling to speak for you, if you have been unable to identify an appropriate agent, or if other people challenge a decision not to use life sustaining medical treatments, your living will can guide your caregivers. A thoughtfully prepared living will is a valuable supplement to appointing an agent."

2005 - National Hospice and Palliative Care Organization 

John J. Paris, Jesuit priest and PhD, was quoted in an Apr. 3, 2005 article titled "Are Living Wills the Answer?," published in the Boston Globe:

"Your proxy needs to know what you want. What's the best way of conveying that? Put it into writing... We can never know what it is under every conceivable circumstance that someone what someone would have wanted."

Apr. 3, 2005 - John J. Paris, PhD 

The American Bar Association, in its website's section on "Law for Older Americans," explained (accessed on July 31, 2006):

"A comprehensive Health Care Advance Directive combines the living will and the health care power of attorney into one document... Because it is more comprehensive and more flexible than the other tools, it is the preferred legal tool."

July 31, 2006 - American Bar Association (ABA) 

The American Medical Association's Council on Ethical and Judicial Affairs said in its June, 1991 report entitled "Decisions to Forgo Life-Sustaining Treatment for Incompetent Patients":

"The designation of a proxy is an effective way to ensure appropriate interpretation of the patient's preferences in specific circumstances which the patient may not have foreseen at the time the directive was issued. On the other hand, the specificity of a living will may better ensure that in a circumstance that was anticipated, decisions will reflect the patient's preferences."

June 1991 - American Medical Association (AMA)