As modern medical science develops new techniques to prolong life, many Maryland residents worry about suffering a crippling illness or injury that would rob them of meaningful qualify of life but leave them in a permanent vegetative state. The Maryland Legislature has addressed these concerns by enacting the Maryland Health Care Decisions Act.
The act, which has become an important estate planning tool, allows Maryland residents to make certain choices about their medical care and to appoint persons to look after their financial interests if they should lose the capacity to do so. The basic tool for accomplishing these ends is the “advance directive,” a document that provides specific directions to health care providers, family members and legal authorities about a person’s preferences for certain types of medical care and post-death matters such as funeral arrangements. An advance directive must be signed by the person making it and be witnessed by two persons who will not benefit by the maker’s death.
One of the most important functions of an advance directive is instructions for health care providers and family members about end-of-life care. A person can use the advance directive in three situations to refuse medical care that merely extends life but does not improve the person’s quality of life. The three situations are imminence of death in spite of the use of life-sustaining treatments, permanent unconsciousness (often called a persistent vegetative state; and endstage condition, which is an advanced, progressive, and incurable condition resulting in complete physical dependency. One example of end-stage condition could be Alzheimer’s disease.
Anyone considering making an advance directive may wish to consult their health care provider for medical advice and an attorney to ensure that the directive is consistent with the other parts of the person’s estate plan.