Advanced Directives
Federal law requires that
any time you are admitted to any health care facility, or served by certain
organizations that receive Medicare and/or Medicaid funds, you must be told
about Colorado’s laws concerning your right to make health care decisions. This
requirement applies to all adult patients regardless of their medical condition.
Upon admission, you will be
given a yellow pamphlet from Hospital Shared Services of Colorado that provides
information about your rights under Colorado law to accept or refuse medical
treatment, including life support.
These are important personal
health care decisions and they deserve careful thought. It is a good idea to
talk about them with your physician, family, friends, staff members of the
health care facility, and possibly with an attorney.
You have the right to have
an Advance Directive, such as a living will, medical durable power of attorney
or health care proxy, or no CPR directive. These documents express your choices
about your future care or name someone to decide for you if you cannot speak for
yourself.
If you are unable to make
your own decisions, Colorado law allows your guardian or your agent “appointed”
or “named” under a medical durable power of attorney to make your health care
decisions. In the absence of an advance medical directive or guardian, Colorado
law allows a person close to you to be a substitute decision maker (proxy) and
requires the physician or the physician’s designee to make reasonable efforts to
contact those close to the patient for the purpose of seeking a substitute
decision maker (proxy).
What is a medical power of attorney?
A medical power of attorney is a document that enables you to appoint someone
you trust to make decisions about your medical care if you cannot make those
decisions yourself. This type of advance directive may also be called a "health
care proxy" or "appointment of a health care agent." This individual stands in
for you when it is time to make medical decisions with your doctor.
A medical
durable power of attorney can cover more health care decisions than a living
will and is not limited to terminal illness. Putting your instructions into your
medical durable power of attorney for your agent to follow tells him or her what
you really want. You can cancel (revoke) your medical durable power of attorney
at any time.
What is a CPR directive?
Resuscitation is an attempt
to revive someone whose heart and/or breathing has stopped by using special
drugs and/or machines or very firm pressing on the chest. This is often called
CPR (which stands for Cardio Pulmonary Resuscitation). If you have a CPR
directive, and your heart and/or lungs stop, then paramedics and doctors,
emergency personnel or others will not try to press on your chest or use
breathing tubes, electric shock, or other things to get your heart and/or lungs
working again. If you do not have a CPR Directive there will almost always be an
attempt to resuscitate. Hospitals and nursing homes respond as if all patients
want resuscitation unless they have completed a CPR directive.
Why do I need an advance directive?
Advance directives give you a voice in decisions about your medical care when
you are unconscious or too ill to communicate. As long as you are able to
express your own decisions, your advance directives will not be used and you can
accept or refuse any medical treatment. But if you become seriously ill, you may
lose the ability to participate in decisions about your own treatment. While it
is better to have a written Advance Directive, oral statements remain important
both on their own and as supplements to written directives.
Although death comes to everyone, many of us tend to fear its
approach and may avoid confronting the issues surrounding the end of life.
Nevertheless, it is important for each person to document his or her wishes in
writing prior to serious illness, physical or mental disability. Otherwise,
those wishes may not be known and may not be honored. Not having those desires
documented can also create an unnecessary burden for loved ones.
What laws govern the use of advance
directives?
Both federal and state laws govern the use of advance directives. The federal
law, the patient Self-Determination Act, requires health care facilities that
receive Medicaid and Medicare funds to inform patients of their rights to
execute advance directives. All 50 states and the
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