In the past, if you were so sick that you were unable to communicate your wishes, the physician or the physician and family members made choices about how to care for you. Now, most physicians and hospitals ask patients to think about these issues while they are well and make them known in a formalized document.
Victoria’s comment:
This just seemed to make sense to me. My doctor asked me during a regular visit if I wanted to make some decisions now about how I’ll be treated if I can’t make decisions for myself. I talked to him about what I wanted done and what I didn’t want done. I signed a form in his office to that effect. I went home and discussed it with my husband and had him fill out a form about his wishes. My doctor has a copy of this form and I have a copy that I keep with my copy of my EKG. Just in case.
The following instruments are formalized ways to as-sure that you are treated according to your wishes: Advance directive An advance directive is a general term that refers to your oral and written instructions about your future medical care, in the event that you become unable to speak for yourself. Each state regulates the use of advance directives differently. There are two types of advance directives: a living will and a medical power of attorney.
Living will A living will is a type of advance directive in which you put in writing your wishes about medical treatment should you be unable to communicate at the end of life. Your state law may define when the livin will goes into effect and may limit the treatments to which the living will applies. Your right to accept or refuse treatment is protected by constitutional and common law.
Medical power of attorney A medical power of attorney (also known as a durable power of attorney for health care, an appointment of a health care agent, or a health care proxy) is a document that enables you to appoint someone you trust to make decisions about your medical care if you cannot make those decisions yourself.
The person you appoint may be called your health care agent, surrogate, attorney-in-fact, or proxy. In many states, the person you appoint through a medical power of attorney is authorized to speak for you at any time you are unable to make your own medical decisions, not only at the end of life.
Do not resuscitate (DNR) order A do not resuscitate order is another kind of advance directive. A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. You can use an advance directive form or tell your doctor that you don’t want to be resuscitated. In this case, a DNR order is put in your medical chart by your doctor. DNR orders are accepted by doctors and hospitals in all states.
Most patients who die in a hospital have had a DNR order written for them. Patients who are not likely to benefit from CPR include people who have cancer that has spread, people whose kidneys don’t work well, people who need a lot of help with daily activities, or people who have severe infections such as pneumonia that re-quire hospitalization.
If you already have one or more of these conditions, you should discuss your wishes about CPR with your doctor, either in the doctor’s office or when you go to the hospital. It’s best to do this early, before you are very sick and are considered unable to make your own decisions.