Public Guardianship is a relationship created by state law in which a court gives one person or entity (the guardian) the duty and power to make personal and/or property decisions for another person (the ward). The court determines if a person’s ability to make health and safety decisions for themselves is significantly impaired by disease, accident, or disability. If so, the court will appoint a guardian to act as a surrogate decision-maker on behalf of that disabled adult. Guardians are sought to be family members or friends, but if said person is unwilling or deemed inappropriate to serve in this capacity, sometimes that appointment can be given to attorneys, corporations, government agencies, or even volunteers.
A public guardian is the guardian of last resort and should only be requested after all alternatives have been exhausted. The public guardianship program provides protection and advocacy on behalf of the disabled adult through case management under the direction of the court provided by a guardianship specialist of a local Area Agency on Aging. For additional information go to: https://dhs.maryland.gov/documents/Brochures/Adult%20Services%20Flyers/SSA-PublicGuardianship_dg.pdf
Advance Directives are legal documents that allow you choose someone to make health care decisions for you in the event you are unable to do so for yourself and/or outline what end of life treatments you do or do not want to undergo. There are three sections to the state’s model Advance Directives Form, which may be completed fully or partially; meaning you may just appoint a decision maker, just document your treatment options, or both.
Living Will is a written, legal document by the signer that spells out the medical treatments that the signee would and would not want to be used to keep them alive, as well as other medical decisions that include pain management or organ donation. If the alleged disabled person made a living will while mentally competent, the document must be honored by health care providers, family members, and courts. However, the existence of a living will (or Advance Directive) may not prevent the need for a guardian, since the disabled person may need to have other non-healthcare decisions made on their behalf. The terms of a living will may only be applicable if the alleged disabled person is terminally ill or in a persistent vegetative state. The document must be carefully reviewed in order to know precisely what specific directions are given.
Surrogate Decision-Making allows relatives or close friends of an alleged disabled person to consent to certain medical procedures and to the withholding or withdrawing of life-sustaining procedures without first obtaining a guardianship of person under certain circumstances (terminal, end-stage, and persistent vegetative state). The (Maryland’s Health Care Decision Act) statue defines “Standard for Surrogates” as any person authorized to make health care decisions for another under this section shall base those decisions on the wishes of the patient and if the wishes of the patient are unknown or clear, on the patients best interest.
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