Advance Medical Directives
Medical Directive are legal documents that allow you to give directions for your future medical care. It is your right to accept or refuse medical care. Advance directives help protect this right. They help make your choices known if you become physically or mentally unable to do so yourself. Advance directives are valuable tools.
Reasons For Medical Directives
- Your family, by freeing them of the responsibility and stress of having to make difficult decisions for you.
- Your healthcare providers, by giving directions for your care
- Advance directives help protect your rights. They can "speak" for you when you can't make your wishes known due to brain damage, coma or other unconscious state, or terminal illness (when death is expected within a short time).
Types Of Advance Directives
- Living will: Written instructions explaining your wishes for healthcare if you can't communicate as a result of a terminal condition or irreversible coma.
- Durable Power of Attorney for Healthcare: Sometimes called a "Healthcare Proxy". A document that lets you name a person (your proxy) to make medical decisions for you, if you become unable to do so.
Making Your Wishes Known
You can use advance directives to request or refuse treatments and to express your feelings about other healthcare issues. For example, you can state your preferences for:
- Cardiopulmonary resuscitation (CPR) - restoring stopped breathing and heartbeat
- Intravenous (IV) therapy, medication through a tube in your vein
- Feeding tubes, inserted through the nose, throat, etc. *Ventilators or respirators, machines used to keep patients breathing
- Dialysis, cleaning patient's blood when the kidneys are no longer working
- Organ and tissue donation
- Pain relief and comfort care
Consider your values before creating advance directives If you were in a coma (or other unconscious condition) or had permanent brain damage or a terminal illness, would you want to:
- Die without pain and suffering
- Prolong life, regardless of the chances for recovery
- Leave your family with good memories
- Have your religious beliefs respected
- Have other honor your decisions
- Not burden your family with difficult decisions
- Be with your loved ones at death
Discuss your thoughts and feelings and talk with family and friends, your healthcare providers, clergy, your attorney and anyone you name as your proxy.
How To Create Advance Directives
- Know your state's laws regarding living wills and durable power of attorney for healthcare (visit www.ag.ky.gov).
- Put your wishes in writing, being as detailed possible. *Sign and date your advance directives; and have them notarized.
- Give your healthcare providers copies for your medical record (if you use a durable power of attorney for healthcare, give your proxy a copy, too).
- Discuss your advance directives with family, friends and your proxy. Give copies to anyone who should be notified in an emergency.
- Review your advance directive regularly. You can always change or even cancel advance directives. Make sure to update the copies you've distributed.
Questions & Answers
What Is A "Do Not Resuscitate Order" (DNR)
- A set of written instructions from a physician telling healthcare providers not to perform CPR or related procedures. Advance directives do not replace DNR orders.
What If I Don't Have An Advance Directive
- Not having an advance directive puts more stress on your family and your healthcare providers. They will be responsible for making important decisions about your care that may be difficult if they do not know your wishes.
Policy Statement Regarding Patients' Rights
- Prior to the start of any procedure or treatment, the patient shall receive whatever information is necessary from the physician to get informed consent. Except in an emergency, the information provided to the patient to obtain informed consent shall include, but limited to, the intended procedure or treatment, the potential risks and the probable length of disability. Whenever significant alternatives of care or treatment exist or when the patient requests information concerning alternatives, the patient shall be given such information. The patient shall have the right to know the name and person responsible for all procedures and treatments.
- The patient may refuse medical treatment to the extent permitted by law. If the patient refuses treatment, the patient will be informed of significant medical consequences that may result from such action.
- The patient will receive written information concerning their rights under state law to make decisions concerning medical care.
- The patient will be given information and the opportunity to formulate advance directives, including, but not limited to, a living will and/or appointment of a healthcare surrogate, and/or execution of a durable power of attorney for healthcare.
- The patient shall receive care regardless of whether or not the patient has or has not executed an advance directive.
- The patient shall have their advance directive made part of their permanent medical record
- The patient shall have the terms of their advance directive complied with by the healthcare providers to the extent permitted by state law.
- The patient shall be transferred to another physician or facility if their physician or agent of their physician or healthcare facility cannot respect the patient's advance directive requests as a matter of "conscience".