Advance directives are documents that state a patient’s choices about treatment, including decisions to refuse treatment to be placed on life-support, and to stop treatment at a point the patient chooses. It also includes requesting life-sustaining treatment if that is wanted. There are several kinds of advance directives. Two are mentioned most often: “Health Care Directive” and “Durable Power of Attorney for Healthcare.” Through advance directives, patients can make legally valid decisions about their medical treatment.
A Health Care Directive is a document that allows you to state, in advance, your wishes regarding the use of life-sustaining procedures. It is implemented only when you are terminally ill and do not have the capacity to make treatment decisions. The Kansas living will is found in a statute titled “The Natural Death Act.” The statute allows any adult to sign a form (relating to themselves only), which states that life-sustaining procedures should be withheld or withdrawn when the decision-making capacity is lost and when such procedures would merely prolong death. Medical procedures deemed necessary to provide comfort or alleviate pain are not considered “life-sustaining procedures” under the act.
For the Natural Death Act Declaration to be effective, two physicians must personally examine the patient and determine that the patient has a terminal illness. The physicians must agree that death will occur whether or not the medical procedure or intervention is done. The form is not effective if the patient is pregnant. If you decide to create a Health Care Directive, it is your responsibility to notify the appropriate people – physicians, family, friends, clergy – and to provide them with copies of your signed Directive. You are encouraged to discuss the details of your Health Care Directive with them and to have it made a part of your permanent medical record.
A durable power of attorney for health care is a legal document that relates only to health care decision making. The person who would make the decisions is known as an “agent” and can be any adult except a physician or other health care provider (including people who work, own or are directors for hospitals and other health care institutions) unless the health care provider is related by blood or marriage to the person signing the document. The powers which can be granted 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 also make all necessary arrangements for hospitalization, physicians or other care, and to request and receive all information and records and to sign releases for records.
The person signing the durable power of attorney for health care can choose which of the above powers the agent will have. Specific instructions can be given. For example, a specific treatment may be prohibited. Requests for treatment, including life-sustaining care, can also be included. The special instructions allow the durable power of attorney for health care to be specific for each individual. The agent and the health care provider must follow the patient’s expressed wishes. This means that they must also respect any wishes that are stated in the Health Care Directive. Unless limited, the durable power of attorney for health care allows the agent to make decisions about withholding or withdrawing life-sustaining treatment in all types of illness (including comas or persistent vegetative states) and is not limited to terminal illness.
To be effective, the document should be notarized. If you should have further questions, or would like more information about advance directives, please speak with your doctor at your next regularly scheduled appointment.