Medical Power of Attorney and Living Will-What's the Difference?

Any trip to the doctor these days begins with a series of rapid-fire questions from a nurse or office assistant. These questions include “Do you have a designated Medical Power of Attorney?” and “Do you have a Living Will?” If they haven't been explained properly to you, they may seem redundant. However, they are very different and very important.

Medical Power of Attorney is perhaps the most familiar of the two. It allows an individual, or designator, to appoint a trusted friend or family member to act as their agent concerning their healthcare if they are unable to make those decisions themselves or are unable to communicate their wishes. Once a medical professional has made this designation, the agent has access to all of the designator's medical records and may work with doctors in all areas when making decisions concerning their care. The document gives the agent flexibility in order to deal with any day-to-day issues that may arise. However, they must make decisions based on what they know would be the personal religious beliefs or values of the designator, so it’s important to let your agent know your wishes. Also important to note is this person will make the decision whether to remove life support, so you need to have that conversation as well.

While Medical Power of Attorney gives the agent flexibility to address various medical concerns, a Living Will, or Advance Directive, focuses solely on end of life or life sustaining issues. A Living Will goes into effect once doctors have determined the patient can no longer communicate and is in a condition from which he or she will likely not recover, such as coma or terminal illness. The terms is whether the person’s condition is terminal or irreversible. The agent's authority goes only as far as what is written in the document itself, as opposed to the flexibility of the Medical Power of Attorney, and concerns specific issues, such as ventilators, resuscitation, and artificial respiration. If a situation occurs that is not covered in the document, the agent then makes a decision based on the values and beliefs of the designator, and not their own.

In the end, the major difference between the two is the amount of authority the two documents afford the designated agents. The Medical Power of Attorney gives the agent the ability to use their own judgment when making decisions about unforeseen issues that could rise from day to day. The Living Will allows the designator to have their wishes specified in a legal document that cannot be altered. The agent and the attorneys must adhere strictly to it.

Another important difference is the agent under the Medical Power of Attorney has all authority over the patient, not the doctors. With the Living Will, of Directive to Physicians, that authority is handed over to the patient’s physician. If you’re not comfortable with doctors managing your life like that, it’s best to skip the Living Will and just have the Medical Power of Attorney.

However, having both Medical Power of Attorney and the Living Will in estate planning is a good idea. Together they make all the tough decisions. One allows the designator to choose someone they trust to care for them on a daily basis in a way they would want to be cared for if they were able to, knowing that person would honor their values and beliefs in doing so. The other allows the designator to choose a physician with their end-of-life decisions.