How does
an advance directive help?
If you sign
an advance directive, your family and your doctor will know who to talk to
about your care or what kinds of treatment you want or don’t want when you are
too sick to decide. If doctors don’t
know your wishes, they will treat you until they can ask your family what you
want. If your family doesn’t know, you
may get treatments you don’t want or which you would stop if you had your
way. In an emergency you will receive
care until doctors can determine your condition and what your wishes are.
What do
I choose in an advance directive?
The form for
Appointment of a Health Care Representative allows you to do four things:
1)
Choose someone to make all your health care decisions beginning
either right away or when you are too sick to decide. That person is called your health care representative. It can be a family member or friend. A witness (not the representative) must sign
your form.
2)
Choose whether or not you want
certain treatments when you are very ill or may not live. For example, you can choose what you wish to
have done, if you are dying, or if you are in a permanent coma. Your representative must follow any choices
you make.
3)
State a desire to donate your
organs. (Your family will make the
final decision, but this will tell them your wishes.)
4)
Choose an alternate representative
and make specific requests regarding your health care.
What
happens if my heart stops?
If your
heart or breathing suddenly stops in the hospital, drugs, machines, and other
means will be used to try to restart them.
This is called cardiopulmonary resuscitation (CPR). CPR is always done unless your doctor writes
an order called a “Do Not Resuscitate” order or DNR. If you have concerns about CPR, discuss them with your doctor
while you are well. If you make an
advance directive that says you do not want CPR, it may not be possible for the
hospital to follow your decision all the time.
For example, if you come to the emergency room and your heart has
stopped, there may be not time to check your advance directive before CPR is
started. If you do not want CPR, your
doctor must write a DNR order for you and put it in your hospital record. Your doctor will then give you a special
orange bracelet designed to alert ambulance crews and hospital emergency
personnel that you do not want CPR.
When
does my advance directive go into effect?
Unless you
state something else, your advance directive will be used only when you are too
sick to choose your care or tell others what care you want. Your doctor will help decide if and when
that time has come and when your advance directive should be used.
Who will decide my care when I’m too sick to choose if I
don’t have a health care representative appointed?
If you do
not name a health care representative, or do not have another form of advance
directive, the doctor will ask your family what treatment you would want, in
this order:
Ø
Spouse (unless legally separated)
Ø
Adult children
Ø
Parents
Ø
Adult brothers and sisters
Ø
Adult grandchildren
Ø
Adult nieces and nephews
Ø
Adult aunts and uncles
If there
are family members whom you do NOT want to make decisions for you, you need to put
this in writing and give it to your doctor or hospital. It can be added to the comments on your Appointment
of Health Care Representative form.
Does my
doctor have to follow my choices?
Yes. If your doctor, hospital, or other place of
health care has any special rules about health care decisions, or if they will
not carry out your decisions, they must tell you. They must then arrange to move you to a doctor, hospital, or
other place that will carry out your decisions.
You can
plan in advance for the time when you may not be able to state your health care
choices. Talk with your doctor, family
members, clergy, and others about your wishes.
Put your decisions in writing.
This may save your family and others from having to make painful decisions
with a lack of knowledge about your wishes.