What Are All Those Medical Documents, Anyway?

Most people think estate planning is just wills and trusts. But when something medical happens, you don’t need a will — you need medical decision documents.

And they’re not all the same. Here’s a quick guide to the key documents every Oregon adult should have, what they do, and when they’re used.

Advance Healthcare Directive (Oregon’s medical power of attorney)

This is the most important medical document. Every adult should have one of these in place. Seriously.

It does two main things:

• Names your healthcare agent — the person who makes decisions if you can’t.

• States your treatment preferences — life support, end-of-life care, pain management.

The Advance Directive is used in the hospital when you are alive but unable to communicate. Remember: it only comes into play when you can’t make decisions on your own.Medical staff will always ask you first if you’re capable of deciding. You aren’t giving up control by putting an Advance Healthcare Directive in place — you’re just naming someone to step in if you can’t speak for yourself.

Your lawyer typically prepares this as part of your estate plan. However, Oregon has created an official state form for this purpose, so you don’t necessarily need an attorney (I often help people with these as a favor).

HIPAA Authorization (medical privacy release)

Without this, family members can’t get updates, talk to doctors, or access medical information.Think of it as: “Let my people in the room.”

This form works even if you can still make your own decisions — it simply allows others to communicate with your care team.It’s separate from the Advance Healthcare Directive and must be signed separately.

POLST (Portable Orders for Life-Sustaining Treatment)

This is Oregon’s version of a DNR. People often ask, “Can you put a DNR in place for me?” The answer is no — a POLST is a medical order, not a legal document, and it’s not part of your estate plan like the previous two.

A POLST is signed by you and your doctor. It tells first responders and hospital staff exactly what to do in an emergency, for example:

• CPR or no CPR

• Full treatment vs. limited treatment vs. comfort care

• Tube feeding decisions

You don’t get a POLST just because you’re doing estate planning. Doctors only sign them when it’s medically appropriate (e.g., serious illness, frailty, advanced age).

Anatomical Gift (organ donation)

You can make this choice in multiple ways:

• On your driver’s license

• Inside your Advance Healthcare Directive

• Through the donor registry

This document expresses your choice about organ donation so your family doesn’t have to guess.

Disposition of Remains / Final Arrangements

This document allows you to record:

• Burial or cremation preference

• Whether you want a memorial service

• Who has legal authority to control your remains

If you don’t designate someone, Oregon law defaults to your “next of kin,” which may not be who you’d expect.Having this document avoids family conflict at an already stressful time.

The Bottom Line

Estate planning isn’t just about what happens when you die — it’s about protecting you while you’re alive.

With the right medical documents in place, you are:

• In control of your care

• Choosing who speaks for you

• Removing burden and uncertainty from your family

Many people skip these steps because, frankly, it’s no fun to talk about.But you owe it to yourself and your loved ones to put these protections in place.

Need Help Getting Started?

If you don’t have these documents — or aren’t sure if the ones you signed years ago are still valid — we can help you get them in place quickly.They’re simple, they make all the difference, and they can save your loved ones from confusion in a moment that truly matters.