Are you prepared for a medical emergency? The COVID-19 pandemic has forced us to think about the many “what-ifs” of suddenly contracting a serious illness. Regardless of whether the medical emergency stems from a global pandemic, to avoid being caught unprepared, everyone should take these four steps to ensure their legal affairs are in order for medical decisions.

The first step is to designate who will make medical decisions for you if you are unable to communicate your wishes. This designation is typically done in a health care power of attorney or a health care directive. For example, if married, you may name your spouse as your primary health care agent, meaning your spouse will make medical decisions for you if you are incapacitated. Your backup agent may be an adult child. You can choose to give your agent broad authority to use their judgment to make any decisions for your health care, or you may give your agent specific direction on how future decisions should be made. If your agent lives near you, they may accompany you to medical appointments at your request or meet you at the hospital in the case of an emergency. If your agent does not live near you, they can communicate with your health care provider via phone or email.

It is worth remembering that North Dakota does have an informed consent law listing the priority of people who can make health care decisions for an incapacitated person. It gives first priority to an agent named in a health care power of attorney, second priority to a guardian, and third and fourth priorities to a spouse and then children, assuming they have maintained significant contacts with you. The informed consent law is a safety net that can carry some families through emergency situations, but it is by no means something to rely upon. By naming a primary agent and at least one backup agent in a health care power of attorney or health care directive, you are proactively making a clear choice about who will handle your medical decisions. This ensures quick decisions can be made on your behalf by the person you choose.

If you do not name a health care agent, and the safety net of the informed consent law does not apply in your situation, your family must obtain a guardianship over you. This requires a family member or other person to step forward and follow the laws of North Dakota in a public and potentially expensive process that results in a judge deeming you legally incompetent and naming a guardian to make medical decisions. Making emergency or end-of-life medical decisions for someone else is stressful enough for loved ones and does not need to be complicated by additional legal hoops to jump through before those decisions can be made. Proactively naming a health care agent is the ideal way to make sure someone can speak for you if you cannot.

The second step in your preparation is to sign a living will. Not to be confused with a last will and testament designating where your property goes when you pass away, a living will contains your end of life health care decisions. Specifically, you will state whether you want to be on life support if two physicians agree you are in a terminal condition and whether you want to receive nutrition and hydration in this scenario. By making these decisions ahead of time, you are giving your health care agent the gift of knowing exactly what your wishes are so he or she can simply carry them out. No one wants to feel like they “pulled the plug” on a loved one.

The third step in your preparation is to designate who has access to your medical information by signing a HIPAA Authorization. The people listed can talk to your health care providers on the phone or in person and have access to your medical records. If you listed your spouse as first health care agent and your adult son who lives in town as the backup agent, consider adding your spouse and all your children, including those who live out of town, on the HIPAA Authorization. This allows everyone you designate to access information about your health, even if they are not making decisions. If you wish for only your currently acting health care agent to access medical information, then no separate HIPAA Authorization is required. HIPAA Authorizations have been especially useful during the pandemic for family members who have been unable to accompany loved ones to the doctor’s office and hospital and have also endured long physical separations from loved ones in nursing homes and assisted living.

The fourth and final step is to make sure the right people have copies of these documents. They will not do you any good if they are just stuffed in the nightstand next to your bed or in the back of a file cabinet in your attorney’s office. Take copies of these documents to all your medical providers and ask for them to be added to your file. Also give copies to the people who are named in the documents. You may also want to sign up for a service such as DocuBank, which keeps copies electronically stored on your behalf and gives you a wallet card with contact information to retrieve these documents if you have a medical emergency. Whether you suffer a heart attack in your home or are in a car crash while in Arizona, the medical team will find the card in your wallet and contact the company for copies of your medical documents.

The recent pandemic illustrates how unexpected circumstances can massively disrupt our lives and our health. We may not be able to prevent the next crisis, whether global or personal, but you can make sure you are prepared for whatever the future holds by visiting with your attorney to complete or update these important legal documents.

This article does not constitute legal advice. Each individual should consult his or her own attorney.