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What is an advance directive?
Advance directives are legal documents that
specify your health care wishes if you are unable to speak for yourself. Washington
state has its own approved forms (Download an Advanced Directive):
a Health Care Directive (also known as a Living Will or Directive to Physicians)
and a Durable Power of Attorney for Health Care can help convey your wishes for
future medical care including non-treatment. Together these forms are known as
an "advance directive". These forms
describe options that are available and can be used to provide any additional
instructions a person may feel is relevant to their end-of-life situation. You
may change your advance directive whenever you choose.
It is important to let your physician and loved
ones know your wishes for treatment should you ever be near death and
unable to express them. Most health facilities assume you
want all available medical treatment, including life-sustaining
care, unless you direct otherwise. If you travel, you may
want to take copies of your documents with you, as other
states may honor these forms.
In the process of completing the forms, you may
wish to talk with your doctor about the issues involved. You may
also want to talk to a counselor or religious/spiritual adviser.
While advanced directives don't require an attorney's involvement,
you may want to discuss any legal questions you have with
your personal attorney.
If you have a serious health
condition, you need to make decisions about life-sustaining
treatment. A new form, called the POLST, can be used to quickly
communicate your wishes as short, clear and specific medical
ordersólike a prescription. This is especially helpful for
health professionals, such as emergency medical technicians,
who may need to treat you in a hurry. Although not technically
part of an advance directive, it is an important part of health
care planning if you are seriously ill. Your physician may
use a POLST from to write orders that indicate what types of
life-sustaining treatment you want or do not want at the end
of life. You need to complete a POLST with your doctor. He
or she will have the form.
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Who can make decisions for me?
If you lose the ability to communicate
and make decisions, Washington state law enables the following
people, in order of priority, to make health care decisions
for you, including withdrawing or withholding care:
- A guardian
with health care decision-making authority, if one has been
appointed.
- The person named in the durable power of attorney
with health care decision-making authority.
- Your spouse.
- Your adult children.
- Your parents.
- Your adult brothers and sisters.
When there is more than one person, such as children, parents,
or brothers and sisters, all must agree on the health care
decision.
(Return to list) Durable Power of Attorney for Health Care
Who would you want making your health care decisions if you were unable? The Durable Power of Attorney for Health Care is a legal document allowing you to name a person as your health care agentósomeone
who is authorized to consent to, stop or refuse most medical treatment for you
if a physician determines you cannot make these decisions yourself. The person
you choose should be a trusted family member or friend with whom you have discussed
your values and medical treatment choices.
Washington State does not require this directive
to be notarized or witnessed. Some states do require it to be notarized; you
may want to do so in the event you travel out-of-state. You can change or cancel
this directive at any time.
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The Health Care Directive ("Living Will")
If you had a terminal condition, would you want
your dying artificially prolonged? The Health Care Directive is the legal document
allowing you to answer this question in writing. This directive is used only
if you have a terminal condition as certified by your physician, where life-sustaining
treatment would only artificially prolong the process of dying; or you are certified
by two physicians to be in an irreversible coma or other permanent unconscious
condition and there is no reasonable hope of recovery. In either situation, the
directive allows treatment to be withheld or withdrawn so that you may die naturally.
You may also direct whether you would want artificially
provided nutrition (food) and hydration (water) stopped under these circumstances.
Also in the directive, you can give further instructions regarding your care.
The Health Care Directive must be signed by you and two witnesses who are not
related to you and will not inherit anything from you. You can change or revoke
this directive at any time.
The Health Care Directive allows people who clearly
do not want their lives artificially prolonged under the above conditions to
make their wishes known.
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Who should have copies of these forms?
The Health Care Directive and Durable Power of
Attorney for Health Care forms are all legal documents once they are completely
filled out and signed with the appropriate signatures.
Signed copies of the completed directives should be included in your medical record, given to any person to whom you give your durable power of attorneyóincluding any alternate people you may have namedóand
to your personal attorney. Originals should be kept by someone you trust and
who can obtain them in an emergency.
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Physician Orders for Life-Sustaining Treatment (The POLST form)
The POLST is a very short and concise way to summarize
your wishes for medical personnel who may be in a hurry and need to treat you
(for example, emergency medical staff called in by 911). It is intended for individuals
with serious health conditions.
The POLST form is voluntary and is designed to
help you and your physician discuss and develop specific plans to reflect your
wishes; assist physicians, nurses, health care facilities and emergency personnel
in honoring those wishes for life-sustaining treatment; and direct appropriate
treatment by Emergency Medical Services personnel. The POLST form will translate
your wishes as expressed in your health care directive and/or durable power of
attorney into clear and specific medical orders. A POLST form can be obtained
at your physician's office. For more information, please see our article specifically
about the POLST form.
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