(With a career spanning 30 years in the medical industry, Maureen Kures is no stranger to end-of-life issues. As an oncology, hospice, and ICU nurse, she was privileged to provide end-of-life care for many individuals. As a nurse supporting bone marrow transplants, she had the opportunity to assist in extending life for many others. This article, used with permission, first appeared at https://www.radiantmourning.com/post/lgbtq-end-of-life-planning.)
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One of the most difficult patient situations I ever experienced happened because two people loved each other. It was devastating. Pat was dying of cancer. Liz has been by her side through it all … the monthly hospitalizations for chemo treatment, the trips for radiation, and loving her through the news that she was going to die. They were terrific together! They had been committed to each other for over 20 years. The devastation came when Pat’s family took over and banned Liz from having anything to do with Pat at the end of her life. This happened over 30 years ago and I can still feel the heartache today. You see, Pat and Liz were a same-sex couple; something Pat’s family refused to recognize. This committed couple who loved each other through life’s ups and downs were separated when Pat breathed her final breath. It should never have been allowed to happen.
In 2015 the Supreme Court recognized same-sex marriage as legal. Yet to my surprise, situations like Pat and Liz experienced still happen today. According to a CNBC article written by Michelle Fox, members of the LGBTQ+ community are less likely to be married. Couples who have been together for years may find themselves shunned by unaccepting family members when life’s crises arise. The one way to ensure this doesn’t happen is to get your end-of-life affairs in order by having legally binding documents drafted. If Pat and Liz had had Power of Attorney for Healthcare documents stating that they had the authority to make decisions for each other, their situation could have been so different.
Whether you are in a LGBTQ+ relationship or a heterosexual relationship, end-of-life planning is critical for a peaceful journey. Don’t be caught off guard because you think you have time to get this done. We never know when the “what if” moment of life will happen!
Here are the bare minimum documents that you should have in place for the person you chose to be able to legally make decisions on your behalf.
- Power of Attorney for Healthcare … your healthcare agent or proxy. This is the document that gives your chosen agent the ability to speak on your behalf if you become unable to do so. Ideally, you should have a primary agent and at least one alternate. The importance of the alternate agent is if something should happen and your primary agent is unable to speak on your behalf. Make sure these are people you have talked to about your wishes and you trust to honor your wishes.
- Advance Directive (aka Living Will) … this document spells out what you would want to be done medically if you are unable to make your own decisions. This includes CPR, Mechanical Ventilation, artificial nutrition, and more.
- HIPAA Privacy Authorization form … this is important because it gives medical personnel authority to share your medical information and health records with people you chose. This could be important in the event that mental capacity needs to be established for the execution of roles such as enacting healthcare or financial power of attorney.
For the LGBTQ+ community who have children, guardianship is critical. Having guardianship established, especially if there is one biological parent, ensures that children will be cared for by those that you choose, not who the state deems “best choice”. Make sure you talk to an estate planning attorney with experience with LGBTQ+ rights.
I am not an attorney and am not giving legal advice. I AM a firm believer that full estate planning is critical for an uncomplicated end-of-life. LGBTQ Lawyers Association has a state-by-state list of lawyers who can help you. Make sure you get your affairs in order so you can live life to the fullest knowing that those who matter most to you have their roadmap to follow.
Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.
Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.
You say that you’re not an attorney, but that obviously hasn’t kept you from giving legal advice. Unfortunately, you are among far too many others in doing the same. There is absolutely NO reason to have BOTH a durable power of attorney for health care AND a living will. The DPAHC gives your designated surrogate the authority to make any and all healthcare decisions for you that, were you able to do so, you could make for yourself. Everyone with a reliable person to designate as attorney-in-fact should have a DPAHC.
A living will is for those who have no such person, or persons, to designate, the “unbefriended” as they are sometimes called. Living wills may not include the right to refuse or discontinue treatment if you are NOT terminally ill or permanently unconscious. In essence, they are more restrictive of rights than a DPAHC.
You may mean well, but those without a legal education should avoid giving legal advice