All individuals have the right to make their own healthcare decisions, including the right to refuse medical or surgical treatment, to confidentiality of their personal and medical records, to know what treatment they will receive, and to know who will be providing the treatment.
They also have another right: that of self-determination. An Advance Directive enables patients to outline, in advance of a serious illness, what kind of treatment they want or do not want, should they become unable to decide or speak for themselves.
A federal law effective December 1, 1991, requires most hospitals, nursing facilities, hospices, home healthcare programs and health maintenance organizations (HMOs) to give patients 18 years of age and over information about advance directives and their legal choices in making decisions about medical care. The law is intended to increase patients’ control over their medical treatment decisions. It is important to remember that state laws differ about the legal choices available to individuals regarding treatment options to be honored by hospitals and other healthcare providers and organizations. In most states, it is not mandatory that patients have an Advance Directive.
Patients are advised to talk to their families, close friends, and physicians before deciding whether they want to complete an Advance Directive.
The two most common forms of Advance Directives are:
A ”Living Will”; (which is also referred to as an Illinois Declaration in the state of Illinois); and
A ”Durable Power of Attorney for Healthcare.”
In addition to addressing other future needs, a Living Will generally states the kind of medical care individuals want (or do not want) if they are unable to make their own decisions. It is called a ”Living Will” because it takes effect while the individual is still living.
In most states, adults may complete and sign a pre-printed form or draw up their own forms. They may wish to speak to an attorney and/or their physician to be certain they have completed the Living Will in a way that their wishes will be understood and followed.
A Durable Power of Attorney for Healthcare, in many states, is a signed, dated and notarized legal document, naming another person, such as wife, husband, daughter, son or close friend, as the individual’s ”agent” or ”proxy” to make medical decisions for them should they become unable to make such decisions. They can include instructions about any treatment they desire or those they wish to avoid.
Individuals may change their minds or cancel either document at any time in accordance with state laws. Any change or cancellation should be written, signed, and dated in accordance with state law.
If an individual wishes to cancel an Advance Directive while in the hospital, the individual should notify the attending physician, family and others who may need to know.
Primary Care Providers are required to note in the patient’s medical record whether an Advance Directive has been executed. It is advised that a copy of the member’s Advance Directive be maintained in the medical records, if available.