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‘Advanced Directives’ – What You Should Know

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Dear Dr. Levister: I recently underwent emergency treatment for asthma. During the hospital registration, I was asked if I had an Advanced Directive. What is it? Is it something I should know about? K.M.

Dear K.M.: “An Advanced Directive,” is an important document that you need to know about. Spelling out your wishes before you get sick can have a profound impact on the delivery of medical care that you receive.

The patient Self Determination Act became law in 1991 as part of the Omnibus Budget Reconciliation Act of 1990. As a result, health care organizations that receive Medicare or Medicaid payments have to provide adult patients with written information about their rights to make decisions about their medical care.

What is an Advanced Directive (AD)? This document provides a person the opportunity to give directions about future medical care. It can also serve as a legal document designating another individual to make decisions for you if you are unable to make those decisions yourself. This document will speak for you if you become incapacitated. You can complete an Advanced Directive document if you are 18 years or older, and of sound mind. You do not need a lawyer to complete an Advanced Directive form. Remember an AD can be modified or even revoked at any time as long as you make your wishes clearly known.

There are several types of Advanced Directives. A Durable Power of Attorney for Health Care allows you to name an individual to make health care decisions when you are not able to do so. Another type of Advanced Directive is called a “living will”, which gets its name from the fact that the document takes effect while you are alive but unable to speak for yourself. Lastly, there is another directive called a Do Not Resuscitate or DNR order. This order tells hospital personnel that you as a patient do not want any life saving resuscitative actions to take place to save your life (e.g. shocking your heart if it stops beating or placing you on a ventilator for breathing). For more information, discuss Advanced Directives with your physician or other health care professional.

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