Advance Directives
Communicating Your Healthcare Choices
Individuals usually make decisions regarding their health care treatment after their physician recommends a course of treatment and provides information about the treatment. These decisions may become more difficult, however, if a patient becomes unable to tell their doctors and loved ones what kind of health care treatment they want. Through documents known as advance directives, individuals can express their treatment preferences before they actually need such care, ensuring that their wishes will be carried out, and that their families and others will not be faced with making these difficult decisions.
Additional information may be obtained from your physician or nurse.
CONSENT TO MEDICAL TREATMENT
Informed Consent
You have the right to decide what may be done to your body during the course
of medical treatment. Your physician will discuss with you the nature of
your condition, the proposed treatment and any alternate procedures that
are available. Your physician will also provide you with information about
the risks associated with certain medical procedures. This information will
help you make an informed decision about the kind of treatment you want
to receive.
Surrogate Decision Maker
If you become unable to make your own health care decisions and do not have
a legal guardian or someone designated under a Medical Power of Attorney,
then certain family members and others can make medical treatment decisions
on your behalf.
ADVANCE DIRECTIVES
Below is some general information on the four types of advance directives
recognized under Texas law. Advance directives can be changed or cancelled
at any time.
Directive to Physicians
A Directive to Physicians, also known as a “living will”, allows
you to tell your physician not use artificial methods to prolong the process
of dying if you are terminally ill. A Directive does not become effective
until you have been diagnosed with a terminal or irreversible condition.
If you sign a Directive, talk it over with your physician and ask that it be made part of your medical record. If for some reason you become unable to sign a written Directive, you can issue a Directive verbally or by other means of non-written communication, in the presence of your physician.
If you have not issued a Directive and become unable to communicate after being diagnosed with a terminal or irreversible condition, your attending physician and legal guardian, or certain family members in the absence of a legal guardian, can make decisions concerning withdrawing, withholding or providing life-sustaining treatment. Your attending physician and another physician not involved in your care also can make decisions to withdraw or withhold life-sustaining treatment if you do not have a guardian and certain family members are not available.
Medical Power of Attorney
Another type of advance directive is a Medical Power of Attorney, which
allows you to designate someone you trust – an agent – to make
health care decisions on your behalf should you become unable to make these
decisions yourself.
You cannot choose as your agent your health care provider, including a physician, hospital or nursing home, an employee of your health care provider, unless he/she is your relative, your residential care provider, such as a nursing home or hospice, or an employee of your residential care provider, unless he/she is related to you.
The person you designate has authority to make health care decisions on your behalf only when your attending physician certifies that you lack the capacity to make your own health care decisions. Your agent cannot make a health care decision if you object, regardless of whether you have the capacity to make the health decision yourself, or whether a Medical Power of Attorney is in effect.
Your agent must make health care decisions after consulting with your attending physician, and according to the agent’s knowledge of your wishes, including your religious and moral beliefs. If your wishes are known, your agent must make a decision based on what he believes is in your best interest.
Out-of-Hospital Do-Not-Resuscitate Order
An Out-of-Hospital Do-Not-Resuscitate Order is a legally binding advance
directive, prepared by, or on behalf of, a patient and signed by the attending
physician of a patient and two witnesses. The order directs healthcare providers
acting in an out-of-hospital setting not to start or continue life-sustaining
procedures.
Declaration for Mental Health Treatment
Another type of advance directive deals with mental health treatment issues
only. A Declaration for Mental Health Treatment allows you to tell health
care providers your choices for mental health treatment, in the event that
you become incapacitated.
LEGAL ASPECTS OF ADVANCE DIRECTIVES
An advance directive does not need to be notarized. Neither this hospital
nor your physician may require you to execute an advance directive as a
condition for admittance or receiving treatment in this or any other hospital.
The fact that you have executed an advance directive will not affect any
insurance policies that you may have.
HOSPITAL POLICIES FOR IMPLEMENTING PATIENTS’ RIGHTS
Formal policies have been adopted to assure that your rights to make medical
treatment decisions will be honored to the extent permitted by law. This
hospital has adopted policies relating to informed consent, and
implementation and treatment decisions under the Directive to Physicians,
the Medical Power of Attorney, the
Out-of-Hospital Do-Not-Resuscitate Order and the Declaration for Mental
Health Treatment.
Contact Information
Complaints concerning advance directive requirements may be filed by calling the Texas Department of Health at 1-800-228-1570
For assistance with Advance Directives, please contact our Social Work Department at 694-5053 email us at socialwork@dchstx.org
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