Advance Health Care Directives in the Age of COVID-19 — Part 2


In light of COVID-19, even if you’ve already created an advance health care directive, you should revisit it to ensure it is up-to-date and addresses specific scenarios related to the coronavirus. In the first part of this series, we discussed some unique circumstances related to COVID-19 and its treatment that you should be aware of when creating or updating your directive. Here, we offer several more provisions you should consider adding to your directive to ensure the document addresses as many potential contingencies as possible during the ongoing pandemic.

3. Permission to undergo experimental medical treatments:


Since there is currently no proven vaccine or other effective treatment for COVID-19, you may consider adding provisions to your directives authorizing your agent to consent to — or withhold consent for — any experimental treatments or procedures that may be developed. Seeing that it could be years before an effective vaccine or cure will be available on a widespread basis, such a provision could be particularly important if you contract the virus while such treatments are still in the trial phase.

4. Express your wishes about intubation and ventilators:


In severe COVID-19 cases, patients often require intubation, which involves putting you into a medically induced coma and inserting a tube into your windpipe, allowing oxygen to be pumped directly to your lungs using a ventilator. However, some directives specifically prohibit intubation, since such measures are often a last resort and used primarily for life-support purposes. Indeed, some people’s greatest fear is being hooked up to a machine just to keep them alive. That said, some coronavirus patients have successfully recovered after being on a ventilator, so you might not want a blanket prohibition of intubation in all cases. While the exact survival rates are still unknown, early reports from New York City health officials found fewer than 20% of COVID-19 patients ultimately survived after being placed on a ventilator. Reports from China and the U.K. found similar rates. You’ll also need to weigh the fact that even if you survive after being placed on a ventilator, you’re likely to require months, or even years, of rehabilitation and may never regain the full quality of life you previously enjoyed. And if you’re elderly or have an underlying condition, the prognosis for full recovery is especially slim. For these reasons, you should carefully review your directives’ provisions regarding intubation and ventilators. There is no right or wrong answer here, so it’s critical your loved ones and medical professionals know what you would want.

5. Consider a liability shield for doctors and hospitals:


Due to the fear of getting sued, some doctors and medical facilities are hesitant to honor advance health care directives in certain circumstances and work with health care agents. To deal with this, consider including language in your directives that “indemnifies” medical providers, facilities, and your agent from any liability incurred as a result of following your directions. People and institutions will be much more likely to fully honor your wishes if they understand they likely won’t get hit with a lawsuit for doing so.

6. Make sure everyone knows about (and has current copies of) your directives:


Even if you have the most well-thought-out and professionally prepared directive around, it won’t be worth the paper it's printed on if nobody knows about them. An advance health care directive goes into effect the second you sign them, so you should deliver copies to your agent(s), your alternate agents, your primary care physician, and any other medical specialists you’re seeing. And don’t forget to give those folks new versions whenever you update the documents and have them tear up the old documents.


The tragic reality of the pandemic is that far too many Americans are at risk of becoming seriously ill and even dying from COVID-19. In light of this dire situation, it’s vital that you and your loved ones take all possible precautions to not only mitigate your chances of catching the virus, but also having the best possible chance of surviving if you should become infected. In the event you become hospitalized with COVID-19, having an updated advance directive in place can make the medical decision-making process for both your health care providers and family much safer and easier, while helping ensure your treatment is carried out based on your personal wishes and values. Given the overloaded state of our health care system right now, facilitating your medical care in this way could ultimately save your life.

This article is a service of the Law Office of Keoni Souza, LLC, an estate planning law firm in Honolulu, Hawaii. We don’t just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That is why we offer a strategic planning session, during which you will get more financially organized than you have ever been before and make all the best choices for the people you love. You can begin by contacting our office today to schedule a planning session and mention this article to find out how to get this $750 session at no charge.


Disclaimer: Unfortunately, I am not your lawyer unless you have paid me for legal advice and we have a signed agreement. Therefore, all information on this website is for informational purposes only and is not legal advice. You should contact an attorney trained to work with families on estate planning matters regarding your specific situation. Use of and access to this website or any of the email links contained within the site do not create an attorney-client relationship between the Law Office of Keoni Souza, LLC, and any users or any other party.

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