Health Care Directives and Living Wills in Missouri: Making Your Medical Wishes Known

Health Care Directives and Living Wills in Missouri: Making Your Medical Wishes Known

No one likes to think about a time when they might not be able to make their own medical decisions. But the reality is, accidents and illnesses can happen to anyone at any age. If you're suddenly unable to communicate, who decides whether you receive certain treatments? Who speaks for you?

That's exactly what a health care directive is designed to address. At The Taormina Firm, we consider health care directives one of the most essential — and most overlooked — components of any Missouri estate plan. Whether you're a young professional in Clayton or a retiree in Wildwood, this document matters more than you might think.

What Is a Health Care Directive?

A health care directive is a legal document that communicates your preferences about medical treatment in situations where you're unable to speak for yourself. In Missouri, health care directives generally come in two forms: a living will and a health care power of attorney (also called a health care proxy).

A living will spells out your wishes regarding specific medical treatments, particularly end-of-life care. For example, you can indicate whether you want life-sustaining treatments such as mechanical ventilation, artificial nutrition and hydration, or CPR if you're in a terminal condition or persistent vegetative state.

A health care power of attorney designates a trusted person — your "agent" — to make medical decisions on your behalf when you're incapacitated. This person can consult with your doctors, review your medical records, and make treatment decisions based on your known wishes and best interests.

Missouri Law on Health Care Directives

Missouri has specific statutes governing health care directives. The Missouri Revised Statutes Chapter 459 addresses declarations relating to the withholding of life-sustaining treatment. Under this law, any competent adult can execute a declaration directing the withdrawal or withholding of death-prolonging procedures.

For the document to be valid in Missouri, it must be signed by the declarant (or by another person at the declarant's direction if the declarant is physically unable to sign), and it must be witnessed by two adults who are not related to you by blood or marriage and who would not be entitled to any portion of your estate.

Missouri also recognizes the durable power of attorney for health care under Chapter 404 of the Missouri Revised Statutes. This allows you to appoint an agent to make health care decisions and is broader in scope than a living will, covering a wider range of medical situations.

Why You Need Both Documents

A living will is limited — it typically only applies in end-of-life situations. A health care power of attorney, on the other hand, covers any situation where you're unable to make medical decisions, whether that's temporary (like being under anesthesia) or long-term (like a serious brain injury).

That's why most estate planning attorneys, including our team at The Taormina Firm, recommend having both documents. Together, they provide comprehensive coverage: your living will states your specific end-of-life preferences, and your health care power of attorney gives your trusted agent the authority to handle everything else.

Choosing Your Health Care Agent

Selecting the right person to serve as your health care agent is one of the most personal decisions in your estate plan. This should be someone who knows your values and beliefs about medical care, is willing to advocate for your wishes — even under pressure from doctors or family members, can remain calm and make difficult decisions during stressful situations, and is readily available and geographically accessible.

Many people in the St. Louis area choose a spouse, adult child, or close sibling. But there's no requirement that your agent be a family member. What matters most is that you trust this person to carry out your wishes.

It's also smart to name a successor agent — someone who can step in if your first choice is unable or unwilling to serve when the time comes.

Common Questions Missouri Residents Ask About Health Care Directives

One question we hear frequently from clients in Brentwood, Crestwood, and across St. Louis County is: "Can my family just make decisions for me without a health care directive?" The answer is: not necessarily. Without a health care directive, your family may need to seek court authorization to make certain medical decisions, which takes time and money — and the outcome isn't always what you'd want.

Another common question is: "Can I change my health care directive?" Absolutely. You can revoke or amend your health care directive at any time, as long as you're mentally competent. We recommend reviewing your directives whenever you experience a major life change — marriage, divorce, a new diagnosis, or the death of your named agent.

People also ask: "Will my health care directive from another state work in Missouri?" Missouri generally recognizes out-of-state health care directives, but there can be complications. If you've moved to Missouri from another state, it's a good idea to have your directives reviewed and updated to ensure full compliance with Missouri law.

The HIPAA Authorization: An Often-Forgotten Piece

There's one more document that goes hand-in-hand with your health care directive: a HIPAA authorization. Under the federal Health Insurance Portability and Accountability Act, your medical information is protected. Without a signed HIPAA release, your health care agent may have difficulty accessing your medical records — even if they have a valid power of attorney.

At The Taormina Firm, we include a HIPAA authorization as part of every estate plan we create. It's a small document that can make a big difference when your agent needs to communicate with your doctors.

Don't Leave Your Medical Decisions to Chance

A health care directive gives you a voice when you can't speak for yourself. It relieves your family of the burden of guessing what you'd want, and it ensures that your medical care aligns with your values and preferences.

If you're in the St. Louis area — from Des Peres to Florissant, Ballwin to University City — contact The Taormina Firm to get your health care directives in place. It's one of the most caring things you can do for yourself and the people who love you.