Exercising your right to choose
Through the past several decades, the ability of medical science to save and preserve lives has increased dramatically. However, this ability has raised some serious questions: Should health-care providers preserve a patient's life after the quality of the patient's life is gone? When a patient can no longer make decisions or communicate decisions about treatment, should health-care providers make those decisions?
Many states - including Kansas - have passed laws allowing people to prepare written directions about their future health-care. These documents are called "advance directives."
In 1990, the federal government passed the Patient Self-Determination Act, a law that requires hospitals to provide written information to adult inpatients concerning their right under state law to make decisions about their own medical care and their right to formulate advance directives.
Two types of advance directives are most commonly used: the "Living Will" and the "Durable Power of Attorney for Health Care Decisions."
The Living Will
The Living Will is a written declaration that makes your wishes known in the event that you have a terminal condition and cannot communicate. (A terminal condition is one that is expected to cause the patient to die.) The Living Will states that life-sustaining procedures should be withheld or withdrawn if you have lost the ability to make decisions and when such procedures would merely prolong death. Medical procedures that provide comfort or alleviate pain are not considered life-sustaining procedures.
To be valid, the Living Will must be signed by you and witnessed by two adults who are not related to you, and who will not inherit from you.
For the Living Will to go into effect, two doctors must examine you and determine that you have a terminal condition. The doctors must agree that you will die whether or not the life-sustaining procedure is done.
The Living Will is not valid while you are pregnant. It is not valid in the operating room, nor is it valid in outpatient settings. In the event an outpatient needs inpatient care, any existing advance directives will be honored.
Durable Power of Attorney for Health-Care Decisions
A Durable Power of Attorney for Health-Care Decisions is a document in which you give someone else the right to make decisions about your health-care in the event that you cannot make these decisions for yourself. That person is called your "agent."
You can name as your agent any competent adult, except a health-care provider (unless that person is related to you by blood or marriage). To be valid, the document must be signed by you and notarized or witnessed by two adults who are not related to you and who will not inherit from you.
The powers that can be granted to your agent include the power to make decisions, give consent, refuse consent or withdraw consent for organ donation, autopsy or the treatment of any physical or mental condition. The agent may make all necessary arrangements for hospitalization, doctors or other care. The agent may also sign releases for your medical records or request and receive your medical records or information about your condition. You can outline in your durable power of attorney document which of the above powers your agent will have.
You can also put specific instructions in your document. For example, you may prohibit a specific treatment. Or you may request treatment, including life-sustaining care. Your agent and health-care providers must follow your expressed wishes. They must also respect any wishes you have stated in a Living Will.