– QUESTIONS AND ANSWERS
Q. What are Advance Directives:
A. Advance directives include
documents such as a living will and durable power of attorney for
health care. DNRs (Do Not Resuscitate Orders) are sometimes
included under the heading of Advance Directives as well.
Q. Why have Advance Directives?
A. It is your right to accept or
refuse medical care and if your aren’t able to communicate your
wishes after you become injured or ill, your Advance Directives will
represent your wishes for your care. They protect your right to
make medical choices. It is now common for hospitals to present you
with Advance Directives to complete upon admission to a hospital so
that medical staff will know your wishes.
Q. How will Advance Directives
impact my family?
A. Should you become seriously
injured or ill, your family will be under tremendous stress.
Advance Directives will remind them of your wishes for care and take
the burden of potentially difficult decisions off their shoulders.
Q. What should I consider before
making Advance Directives?
A. Your religious beliefs, feelings
about quality versus quantity of life, ability to make you own
decisions, medical intervention and relieving your family of
difficult decisions should all be factors when you consider making
an Advance Directive.
Q. Should I speak to anyone before
signing an Advance Directive?
A. It is good to speak with family
and friends, your pastor or priest, your physician and your attorney
prior to signing Advance Directives.
Q. What exactly is a Living Will?
A. Living wills are written
documents that explain your wishes in the event that you are
diagnosed with a terminal condition. This document must be drafted
and signed while you are still able to communicate your wishes.
Q. What is a Durable Power of
Attorney for Health Care?
A. This is a written document and
is not the same as a Power of Attorney or General Power of Attorney
which are used to convey legal and financial decision making to
another individual. This document specifically addresses health
care decisions. It is sometimes called a Medical Power of Attorney.
Q. When do these documents become
A. If two physicians determine that
you are in a coma (or other unconscious condition), that you have
sustained permanent brain damage or are terminally ill, the living
will and durable power of attorney for health care are used to make
you wishes known.
Q. Where should these documents be
A. You should give a copy of your
advance directives to your physician to be kept in your permanent
medical record. Your spouse or closest family members should have a
copy. It is also a good idea to keep a card in your wallet that
tells what advance directives you have and where they are located.
Q. Can I change advance directives
once I have made them?
A. Yes, you should review your
advance directives regularly and make any changes as necessary. Be
certain to inform your physician and family or proxy of any changes.
The following is a brief definition
and example of the three major types of Advance Directives:
Living Will – This document provides
specific instructions regarding medical treatments should two
physicians determine that you are no longer able to voice your
wishes because you are in a coma, have irreversible brain damage or
are terminally ill. You may specify whether or not you want
mechanical breathing (respirator), to be fed through a tube,
intravenous feeding, surgery, heart/lung resuscitation (CPR) or any
other procedures. This document must be completed by an adult who
is of sound mind in order for it to be a legal document. For
example, Beth is a 62 year old with terminal cancer. She has chosen
to complete a living will and does not want any of the above medical
options to be used as she nears the end of her life. She desires
her caregivers to provide comfort measures only. Comfort measures
include pain relief, food and water as tolerated and non-invasive
Durable Power of Attorney for Health
Care – This is also known as a Medical Power of Attorney. In this
document you name a specific individual and usually an alternate to
make medical decisions for you. These decisions include choosing
physicians, authorizing medical care or treatment and placement in a
rehabilitation or health care facility as needed. For example, Fred
is 50 years old but is concerned because both of his parents died of
Alzheimer’s disease. He appoints his wife, Ann, as his POA and she
will make health care decisions for him when he is no longer able to
Do Not Resuscitate (DNR) – This
states that you are refusing measures to revive your heart if it
stops beating. This would go into effect any time your heart stops
beating and does not require a determination by two physicians as a
Living Will does. For example, Ben is a healthy 90 year old who
could have a heart attack. He does not have any terminal illnesses
or other conditions which would trigger a Living Will. He has
decided that because of his convictions, when he dies he does not
want any medical intervention but rather wants to let his life take
its natural course. He has signed a DNR and does not want to be
resuscitated in the event of a heart attack.