Quote Originally Posted by Capt. Bob View Post
Doc, So sorry for this continuing tough saga of Kathy's fight for survival following that tragic accident. Regardless of one's faith, this whole story really cries for all of us to understand before things go South in our lives to do a few things that allow for our wishes to be complied with.

For those of us who do not know what a Living Will is and I am not an attorney, it is a document that essentially articulates our wishes for care in the event that we become unable or incapacitated to make medical decisions for ourselves. This document does not have to be filled out by and attorney and there are generally no costs associated with it. In addition to the Living Will, a Medical Power of Attorney allows a selected person to make medical decisions for us in the event of incapacitation or other seriously compromising conditions.

Both my wife and I have these documents on file with our Family Doctor and also have them shared with several other sources in the event that both my wife and I were faced with some of the tough challenges you and Kathy have been faced with.

Life is precious but at times unpredictable and people of faith and those that do not believe in a higher power can find comfort in having our wishes carried out in the event of medical crises.

My wife and I hope that the card we sent has comforted you and Kathy as well as some of your other family members. I think all of us sense how much you care about Kathy and how much she has cared for you and that we are all hoping that everyone finds some peace and comfort in whatever way best works for you all.
Yes, we should have had living wills. We just never got around to it. Under a new Indiana law that came into effect on July 1, 2018, the hierarchy of who can say what happens is very clear cut. It blows my mind that this law started 6 days before her accident. Here is what it states. Very clear cut.

The second change is arguably more significant and relates to medical consent by family members or friends when a patient is incapable of providing medical consent on his or her own behalf (e.g., if the patient is unconscious, sedated, or assessed as mentally incompetent). For several decades, Indiana statutes have specified a list of individuals that could provide medical consent under such circumstances (including a spouse, a parent, an adult child, an adult grandchild, an adult sibling, or a grandparent). However, Indiana law was previously silent on the hierarchy of such individuals in the medical consent process. Such a process left health care providers in untenable situations in which family members disagreed as to medical intervention issues. Hospitals would often seek appointment of a court-appointed guardian for the incapacitated patient to sort out disagreements amongst family members. The appointment of a guardian often caused delay and confusion during an already difficult medical situation. However, effective July 1, 2018, health care providers can rely on a priority order of hierarchy, found under I.C. § 16-36-1-5, for issues concerning medical consent. Generally, the hierarchy specifies the following individuals for medical consent:

  1. A judicially appointed guardian;
  2. A spouse;
  3. An adult child;
  4. A parent;
  5. An adult sibling;
  6. A grandparent;
  7. An adult grandchild;
  8. The nearest other adult relative in the next degree of kinship;
  9. A friend; or
  10. The individual's religious superior.

The updated law also creates certain exceptions to the hierarchy for spouses who are legally separated, and prohibits individuals from providing consent if they are subject to a protective order or the subject of a pending criminal charge in which the incapacitated patient is the alleged victim.
The changes to Indiana’s medical consent laws and end-of-life POST directives are beneficial to both patients and health care providers. By allowing PAs and NPs to assist patients with POST directives, patients faced with a terminal disease or other serious illness will have easier access to POST directives. The new hierarchy for medical consent provides patients and providers clear guidelines for medical consent issues. If patients have concerns about the hierarchy established under the updated law, such individuals are free to create an advanced healthcare directive (a.k.a. “living will”) with an alternative hierarchy that would supersede the generic hierarchy established under the new law. Indiana’s updated law does not prohibit or overrule advanced healthcare directives – in fact, it encourages such arrangements. As Indiana’s updated law is implemented in the coming months, health care providers and patients will benefit from the clarity provided by the updated law.