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Making Care Decisions

Advance Directives

Advance directives are statements made by the patient that describe the treatments that should or should not be given in the event a medical situation arises which requires a decision about therapy, and the patient is unable to speak for him or herself.  Patients can be sure that their wishes are followed by executing advance directives. While laws vary in each state, most recognize at least one of two advance directives:

Health Care Proxy
A Living Will

Health Care Proxy

A Health Care Proxy, also referred to as a "Medical/Durable Power of Attorney for Health Care," is a legal form that authorizes a person of the patient's choice to make health care decisions for the patient if he/she is unable to do so.

The person who is appointed may be referred to as the patient's health care agent, surrogate, attorney-in-fact, or proxy. This individual can be a friend, family member, or partner. It should be someone who is familiar with the patient's views about medical care, including the role of life-sustaining treatments like mechanical respiration, and will uphold his or her wishes as medical situations arise.

In order to designate a health care agent, a form must be filled out, which becomes a legally binding document. This form must be signed by the patient, health care agent, and a witness. After the proxy form is signed, hospitals, other health care facilities, and all health care professionals are legally obligated to follow medical instructions given by the health care agent, if the patient is unable to communicate. Agents can be changed at any time if the individual decides that someone else would be better able to represent him or her. It is important for everyone to have a copy of the patient's Health Care Proxy, including his/her doctors and hospital, and that it is in the patient's chart.

Health Care Proxy forms can be obtained from the hospital or by contacting:

Choice in Dying/Partnership for Caring
1035 30th Street, NW
Washington, DC 20007
(800) 989-WILL (9455)

Living Will

A Living Will is a set of written instructions that outline the patient's health care wishes at the end of life. If the patient completes a Health Care Proxy form, but also has a Living Will, the Living Will provides the instructions for the proxy.

Advantages of Advance Directives:

Help patients express their future wishes about medical treatment.
Ensure that patients will not be given medical treatments they do not want.
Take pressure off family members if decisions must be made about medical care and patients are unable to communicate.
Patients can choose a person they feel will best represent their wishes.
Patients can change living wills or health care proxies at any time.


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