"This time, with a PAD, I did not receive any treatments that I did not want. They were very respectful. I really felt like the hospital took better care of me because I had my PAD. In fact, I think it's the best care that I've ever received."Read More...
Missouri Q and A
Ten commonly asked questions about PAD's for Missouri
Please note: the following 10 FAQs are designed to provide a quick and accessible guide to what your state’s Statutes say – or do not say – about PADs. The FAQs do not attempt to provide a complete picture of the law in your state, nor can they take the place of legal advice. The answers were accurate when written in November 2006.
1. Can I write a legally-binding psychiatric advance directive (PAD)?
Yes, by appointing an agent. Missouri’s Durable Power of Attorney for Health Care Act allows you to appoint an agent to make healthcare decisions for you if you become incompetent to make those decisions yourself. Healthcare decisions may include decisions about mental health. The Missouri Bar Association has published a standard form for this purpose, available here . Although it is not mandatory, it is advisable to use part I of this form to appoint an agent because of the required wording it contains.
Yes. The general rule is that your agent can make any health care decision that you could have made if you were able to. You should be aware that there are exceptions to this general rule: see question 9 below.
The statute requires that your agent “seek and consider information” relating to your diagnosis, prognosis, benefits and burdens of the proposed treatment, every time a decision is made. This creates a “best interests” standard. However, the likely effect of the statute is that your agent is also required to follow your instructions as far as possible. It is therefore important that you discuss your wishes with your agent.
Yes. As explained above, it is not possible to write advance instructions only. If you wish to create a PAD, you must appoint an agent, but the extent to which you also document your decisions is up to you.
No. All that is required is that two licensed physicians believe you are incompetent to make the decision. The physicians must document that decision in your medical records.
Because the statute is primarily concerned with end-of-life decisions, it does not specify when a psychiatric decision may be overridden by a clinician. However, it is important to note that mental health care providers might be justified in declining your agent’s instructions if you were considered a danger to yourself or others, or otherwise in an emergency.
The document appointing your agent is valid until revoked. You may revoke it at any time and in any way which demonstrates that you intend to do so.