Advance Directives

By Nicole Combs
Types of Advance Directives

Living Will
Durable Power of Attorney
Do-Not-Resuscitate Order
Do I need a living will?

Of U.S. deaths, 2555% occur in health care facilities.

Aggressive medical intervention leaves nearly two million Americans
confined to nursing homes.
As many as 30,000 persons are kept alive in comatose and permanently
vegetative states.
Studies indicate that 70-95% of people would rather refuse aggressive
medical treatment than have their lives medically prolonged in
incompetent or other poor prognosis states
Living Will continued

The living will is the oldest form of advance directive.

A living will is executed by a competent adult expressing the individuals
wishes regarding treatment should the individual become affected with
certain conditions.
Example: Persistent vegetative state or terminal condition.
Individual would no longer be able to communicate on his or her own.
Express wishes about the use or foregoing of food and water, if supplied
via tubes or other medical devices.
Can be very specific or very general.
Durable Power of Attorney for
Healthcare Decisions.
An individual while still competent, designates another person to make
healthcare decisions consistent with the individuals wishes on his or her
behalf.
Durable means that the document is in effect when the individual is
no longer competent.
The appointed healthcare proxy has, in essence, the same rights to
request or refuse treatment that the individual would have if still
capable of making and communicating health care decisions.
Do-Not-Resuscitate Order

DNR
Always specifies an individuals wish NOT to receive treatment.
Usually used by elderly individuals or chronically ill
Directs healthcare providers from performing CPR if the individual
experiences cardiac or respiratory arrest.
Do-Not-Resuscitate Order continued

Patient and physician should have a discussion

Consent form should be signed by the patient
Physician should write an order in the patient charts
State law provides the framework for completing DNR orders and forms
Also known as No Code or Allow natural Death
Patients who are DNR can continue to get chemotherapy, antibiotics,
dialysis, or any other appropriate treatments.
What if I dont have
advance directives?
The lack of advance directives can
result in legal battles regarding
undocumented wishes of
individuals who become legally
incompetent.
References

https://en.wikipedia.org/wiki/Advance_healthcare_directive
Gordon, L., & Sayles, N. (2016). Health Information Management
Technology An Applied Approach Fifth Edition, 201
https://en.wikipedia.org/wiki/Do_not_resuscitate