By law in Pennsylvania, all adults of
sound mind have the right to decide their own health care treatment. That means
you have the right to accept, to refuse, and to stop medical treatment. But what
would happen if you became very ill or badly injured and were unable to tell
your doctor or family what medical choices you would make for yourself? You can
plan ahead to ensure your wishes are known by preparing an Advance Directive.
An Advance Directive is a legal document
written in advance to help ensure that your personal values and wishes are known
when medical decisions need to be made.
At The Washington Hospital, we provide the
best care available and will work with patients and families to provide
individualized treatment. We respect your right to make medical decisions.
Modern medicine has made it possible to
extend the lives of both young and old beyond the point when many cannot make
their decisions known. While most of us feel it is very important for someone to
know how we feel about "machines" to keep us alive--very few of us do
anything about it. The only way to ensure that your values and wishes are
considered is to use a legal document called Advance Directive. An Advance
Directive protects your right to decide for yourself
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What is an Advance
Directive?
An Advance Directive states your written
instructions about medical treatment. It is made before you are ill and not able
to speak for yourself. These instructions allow you to make legal decisions
about your future health care. A Living Will and a Durable Power of Attorney for
Health Care Decisions are advance directives.
An Advance Directive offers you a way to
plan ahead for future health care choices.
In Pennsylvania, your Living Will or
Durable Power of Attorney for Health Care Decisions is honored.
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Who can make an Advance
Directive?
In Pennsylvania, you can make an Advance
Directive if you are of sound mind and:
18 years of age or older
or
graduated from high school
or
married
How
can I make an Advance
Directive?
Our social workers are available to assist
you with your Advance Directive needs. Often patients need additional
information, assistance, and emotional support as they consider the many
sensitive issues surrounding Advance Directive decisions. It is important to
have all the necessary information in order for you to make an informed
decision. Our social workers can provide you with education, forms, and
counseling services as needed. Ask your doctor or nurse to notify a social
worker. You may also call directly at 724-223-3291.
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Health Care Options
Life-saving (life-support) treatments help
restore you to your same or near-same quality of health. Life-sustaining
treatments help delay death if your illness cannot be cured.
What are life-saving
treatments?
Life-saving treatments may also be called
life-support treatments. They are used during an emergency medical crisis.
These treatments are short-term and return the patient to the same or near
same quality of life. Some restore a normal heartbeat and breathing. Others
include machines that take over the job of vital organs, such as lungs, the
heart, or the kidneys. Some treatments include special medications and
artificial feeding methods.
What are
life-sustaining treatments?
When your condition cannot be reversed or
cured, these same treatments are used to prolong life and delay death.
It is at this point that an ADVANCE
DIRECTIVE is needed.
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Life-saving
and Life-sustaining Treatments Defined
CPR
(cardiopulmonary resuscitation)
Chest compressions and assisted
breathing done to try to revive a person when the heartbeat
and breathing have stopped.
Defibrillation or
Cardioversion
An electric shock given to the heart
to return it to a normal beat.
Medications
Emergency drugs given to restore or maintain a steady
heartbeat or blood pressure during a crisis and/or antibiotics
to fight infection.
Ventilator
(or breathing machine)
A machine which helps you breathe
or breathes for you by pumping oxygen into the lungs.
Kidney Dialysis
A method to clean the blood of waste and fluid when
the kidneys no longer work properly.
Intravenous (IV)
Fluids
Salt and/or sugar fluids given through a vein.
IV fluids are routine for most hospital patients even if not seriously
ill. A special IV fluid may be given for nutrition if you cannot eat or drink.
Tube Feeding
Liquid or food given through a tube placed in the stomach
when you can no longer chew or swallow.
Discuss these treatments with your doctor.
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Organ
and Tissue Donation
There have been stories in the media about
the need for organ donations.
What are organ and
tissue donations?
It is a special way for you to help save
someone elses life through transplant surgery after you die. Today, about 25
different organs and tissues may be used, including corneas of the eyes,
heart, liver, bone and cartilage, kidneys, bone marrow, and skin.
Who decides about organ
and tissue donations?
You, the patient, may indicate your
decision by having signed a donor card, by expressing your wishes, or noting
them on your Advance Directive, or drivers license. In most cases, the family
decides at the time of the patients death. Organ and tissue donations are
strictly voluntary, but there are limiting factors. If you have any questions
or concerns, talk with your doctor or
nurse.
What is brain death?
We usually think of death as the stopping
of the heartbeat and the breathing process. However, new technology has
created another type of death. Brain death means a total absence of brain
activity. Heartbeat and breathing may continue only with the help of special
machines.
By signing a donor card or noting it on
your Advance Directive or drivers license, you can make known your choice about
organ and tissue donation.
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Your Values
and Your Choices
Spiritual Needs
We are aware of the many different ethnic
and religious backgrounds found within our community. Religion helps to shape beliefs and values. Your religious viewpoint may make a
difference in your decisions about life-sustaining treatment and an
Advance Directive.
While your medical needs are of great
importance, your spiritual needs cannot be overlooked while you are ill. We
respect your religious beliefs and the effect they have on your life choices.
For many people, talking with the clergy can help them think through their
feelings and wishes during difficult times. Your religious beliefs may provide
you with hope, understanding, and comfort.
We encourage you and your family to use
your own spiritual advisor or our Department of
Pastoral
Care
if you need help making health care choices. We, at The
Washington Hospital, will assist in any way possible.
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Preparing You to
Discuss Your Choices
It is important for every adult, young or
old, to have an Advance Directive. A serious illness or accident can happen at
any time and at any age. Would your family and doctor know your life choices
if you could not make decisions about your medical care? Preparing an Advance
Directive will help protect your right to make health care choices for
yourself.
The word "dignity" is often used
when talking about end-of-life decisions. Dignity is the sense of worth that
comes with having the freedom to decide what is proper and improper.
"Self-reliance" -- the ability to make decisions for yourself -- is
the word most often used by patients to describe what dignity means to them.
We acknowledge your dignity when we honor your right to make decisions about
yourself. Making an Advance Directive will protect that right.
Before making an Advance Directive, think
about what in life is important to you. Are there limitations or conditions
that would make your life no longer meaningful? Clarify your feelings. This is
the first step in making end-of-life decisions.
You need to understand what
life-sustaining treatments can and cannot do. Talk with your doctor. Think
about the degree of recovery that you can expect from these treatments. What
will be the quality of your life? How important is survival compared with
being independent?
While you are healthy, think and discuss
what is important to you. Your beliefs play an important part in the way you
think about life and death. How you view the quality of life varies with each
individual. Understanding what you value may help you with your health care
choices.
We hope the preceding information will
help you in deciding for yourself about your wishes and life-sustaining
treatments.
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What is a Living
Will?
A Living Will is an advance directive that
describes your wishes in writing about what medical treatment you want or do not
want. A Living Will is used only when you are terminally ill or permanently
unconscious and cannot make your choices known.
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Of Page
What is a Durable
Power of Attorney for Health Care?
A Durable Power of Attorney for Health
Care Decisions is an advance directive that names in writing the person that you
want to make your medical decisions at any time you cant speak for yourself.
This legal form may also include your instructions regarding life-sustaining
treatment.
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Questions
And Answers
Can I choose some
life-sustaining measures but not others?
Yes, if you want everything done for your
illness but would not want reviving measures (CPR) or a specific
life-prolonging treatment, you have the choice.
What if I do not
want any life-sustaining treatment attempted?
After carefully considering all options,
you have the freedom and the right to make this choice.
What if I want only to
be kept comfortable?
You may request "comfort measures
only." You may be assured that, for all patients, we make every effort to
provide comfort, to relieve suffering or pain, and to make the patient
function as fully as possible.
When should my choices
be made?
It is best to decide about life-sustaining
treatments before a health crisis occurs. Therefore, the best time is while
you are in good health and can think about and plan your choices according to
your own values and beliefs.
At The Washington Hospital, all
life-sustaining treatments will be used unless you and your doctor agree to
other health care choices.
Whats the best way to
let my family and doctor know about my choices?
We often assume our family knows our
wishes. They may not. Open and honest discussion with your family and doctor
should occur while you are healthy. See how they feel about following your
wishes. However, talk is not enough. You should write your choices on paper.
Plan ahead and prepare a Living Will or name a Durable Power of Attorney for
Health Care Decisions.
What should I do if my
family does not feel comfortable with my choices?
Remember, these are your choices. If your
family members disagree with your choices, talk with a trusted friend or
advisor who you might want to consider to be your Durable Power of Attorney
for Health Care Decisions.
Does a "durable
power of attorney for health care decisions" mean I have to appoint a
lawyer to make health care decisions for me?
No. You are allowed to appoint anyone you
wish. It is generally not a good idea, however, to appoint your doctor. You
should appoint someone else you know, trust, and with whom you can talk over
your wishes.
Make your choices before an illness
happens. Talk with your family and doctor.
In Pennsylvania, your Advance Directive
must be signed by you and two witnesses and dated. Each state has different
legal requirements.
What if a person I name
to make decisions for me dies before I do?
It is always a good idea to name a second
person to make decisions in case your first choice is not available.
Do I need to involve a
lawyer when I prepare my Advance Directive?
No. You may prepare your Advance Directive
yourself. However, you may wish to consult a lawyer to determine if your
wishes can be carried out under the law of Pennsylvania and if your wishes are
stated accurately.
What should I do
after I have written my Advance Directive?
Copies of your Living Will or Durable
Power of Attorney for Health Care Decisions should be given to all those
people who might be involved in future medical decisions for you, such as your
doctor, family, other health care provider, and friends. At the time of an
admission to the hospital, you or your family will be asked to state your
wishes to the doctor and other health care providers. Bring a copy of your
Advance Directive with you to the hospital. This copy will be included in your
hospital chart during your hospital stay.
Keep your Advance Directive in an
easy-to-find place. Do not lock it up. Make sure your family knows where your
Advance Directive can be found. Give your family and doctor a copy.
After I am discharged
from the hospital, will my Advance Directive be kept on record for future
admissions?
No. Your decisions are only kept on record
until you are discharged. You must state your wishes each time you are
readmitted to the hospital. This way the hospital can be certain that it has
your most current information.
I have a Living Will.
If I am admitted to a hospital in good health for an unexpected health problem
or a planned short-term procedure, will I receive CPR if
my heart stops?
Yes. All emergency care and
life-sustaining treatments, such as CPR, will be done. A Living Will is used
only when you are terminally ill or permanently unconscious and cannot make
your choices known.
Talk to your doctor. Health care plans
should be decided together.
When will my Advance
Directive instructions be used to determine my medical care?
An Advance Directive becomes active when a
copy is provided to your attending doctor and the hospital. A Living Will is
used when your doctor confirms that you are unable to speak for yourself and
in a terminal condition or in a state of permanent unconsciousness. A Durable
Power of Attorney for Health Care Decisions is used at any time that you
cannot speak for yourself.
What happens if the
hospital or my doctor refuses to follow my Advance Directive?
If your doctor, or the hospital cannot in
good faith comply with your wishes, every reasonable effort will be made to
transfer you to the care of another doctor or hospital.
What happens if I am
pregnant?
Pennsylvania law requires that a pregnant
woman who has an Advance Directive, except in rare situations, be provided
with life-prolonging treatment, nutrition, and hydration.
Having an Advance Directive is not enough.
Your doctor needs to write his orders based on your choices. It is important
that your doctor knows your wishes.
Your doctor does not have to follow your
wishes if they conflict with his or her personal beliefs. Talk to your doctor
while you are well. You have the right to change doctors.
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What is the hospitals
position on Advance Directives?
We are committed to:
