Advanced Directives

The Colorado Hospital Association provides a complete look at the decisions you’re entitled to make about your healthcare.

Download the pamphlet “Your Right to Make Healthcare Decisions”

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 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 District of Columbia have laws recognizing the use of advance directives.