Advanced Directives

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JACC
4101 22nd Place
Lubbock, Texas 79410

phone: 806-725-8000
fax: 806-723-6412

General Information:
info@joearrington.org

Advanced Directives

Downloads: Advanced Directives PDF and Medical Power of Attorney PDF

There may come a time when you or a member of your family becomes seriously injured or critically ill. Grief and shock may dominate your emotions, affecting your ability to make important medical decisions. These decisions include whether to withdraw “life-sustaining” treatment, who should make such decisions in the event that you are unable, and whether your organs should be donated in the event of your death.

Advanced Directives are legal documents that tell your doctor your wishes about medical treatment when you are unable to communicate these decisions or choices yourself. Generally, these documents are signed in advance of treatment to let your doctors and healthcare team know your wishes. For example, if you fell into a coma, they would let the doctor know your wishes for care or say whom you would wish to make the decisions for your care.

Advance directives are not required for admission to Covenant Health System or if you are under treatment at Joe Arrington Cancer Research or Treatment Center, but we strongly recommend that you have these documents in place. Our patient representatives can provide you the forms and instructions for having them completed so they are legally binding. Our chaplains will be more than happy to assist you in filling out the documents correctly.

It is important that you discuss your wishes with your loved ones so they will respect these documents if they are called into use, especially if you are naming someone to act on your behalf. Make sure you give copies of these directives to your family, doctors and any healthcare facilities where you receive treatment. You can change your mind any time after creating these directives–simply destroy the original and let your family, doctor and anyone else with copies know of your change of mind.

These directives only go into effect when you are no longer able to make your own healthcare decisions (no longer able to provide informed consent). These advance directives will be placed in your hospital chart, but it is important that you make your healthcare providers aware that you have made advance directives.

If you do not make any advance directives, there is a chance you may receive life-prolonging procedures that you might not wish to have. If you have no advance directives, your healthcare providers will look to others to make life-prolonging care decisions in the following order:

Your guardian, if the court has appointed one, or a healthcare surrogate you have appointed
Your spouse
An adult child (if you have more than one, the doctor will seek opinions from all who are reasonably available to consult)
Either of your parents
An adult sibling, or if you have more than one, the doctor will seek opinions from all who are reasonably available to consult
Any other of your adult relatives who have shown special care or concern for you, and who are familiar with your activities, health, religious or moral beliefs.

Advanced Directives FAQ

Q: Why should I be concerned about making advance directives for my healthcare?
A: Accidents happen to people of all ages. You could suddenly become incapacitated by an accident or illness, or by a condition that could gradually (or sometimes quickly) lead to your loss of decision-making capabilities.

Q: Do I have a right to direct my care?
A: Whether you are conscious and able to communicate, or unconscious and unable to communicate, you have two basic rights regarding medical treatment. First, you have the right to have the situation clearly explained to you or your surrogate. Second, you have the right to decide what healthcare you will receive, or will refuse.

This does not mean a doctor or a hospital must follow your instruction if they believe it is seriously wrong. They may notify you that they are unwilling to abide by your instruction. If you insist, it is the physician’s responsibility to find doctors and a hospital that will agree to follow your instruction.

Q: What information do I need to make good healthcare decisions?
A: In order to make a reasonable decision, you have a right to the following kinds of information:

Your doctor’s diagnosis and prognosis of your medical condition.
What tests might determine the causes, or possible causes of your condition?
What treatment alternatives are available, including experimental or risky treatments that might be helpful?
What risks and benefits are involved in the different treatments?
What are the consequences of not having treatment?
What does your doctor recommend?
What are the expected costs and other burdens of proposed tests and treatment?

Q: How can I influence my care if I am unable to decide for myself or I am unable
to communicate?
A: It is important you communicate clearly, in advance, what you would want if you should become unable to make or communicate decisions. In such situations, your reasonable directives should be followed if they are known.

In an emergency (and unless they know you would refuse care), healthcare professionals will do what they believe is necessary to save your life or prevent serious injury if you are unconscious. For adults, healthcare professionals will in many circumstances accept the reasonable directions of a spouse, an adult child or a surrogate. When the family disagrees, either someone in the family or the healthcare provider may ask a court to appoint a legal guardian to make decisions for you. For children, parents or a guardian usually make decisions about treatment.

Q: How can I communicate my wishes regarding healthcare?
A: There are two major instruments that can be executed under Texas law in order to have a person’s desires regarding medical treatment made known, in the event that the person is later unable to make such decisions.

The first is the Directive to Physicians under the Texas Natural Death Act. This is also known as the “living will.” It allows a person to tell physicians to withhold or withdraw life-sustaining procedures in the event of a terminal condition. It also allows a person to designate another individual to make treatment decisions if the person becomes comatose or incompetent (mentally or physically incapable of communication).

The second instrument is the Medical Power of Attorney. This special power of attorney allows a person to appoint an individual, and as many alternates as desired, who will be authorized to make any healthcare decision on behalf of the person granting the power of attorney (called the Principal), if the person (i.e., Principal) later lacks the capacity to make healthcare decisions for himself or herself. This allows a person to select, in advance, those persons he or she would want to make healthcare decisions in the event he or she later becomes incompetent.

Q: Does the Church offer guidance for making treatment decisions?
A: The Church, both Roman Catholic and United Methodist, teaches that all life comes from God and that all human beings are created in the image and likeness of God. This gives human life its special meaning. But, Church teaching also recognizes that death is an inevitable part of life and is a transition to eternal life.

Church tradition also recognizes and respects reasonable individual autonomy - the right and responsibility of each person to make reasonable treatment choices. This includes choices to refuse or to discontinue life-sustaining treatment that is ineffective and/or overly burdensome. It is ethically acceptable to discontinue medical treatment when the burden of the treatment outweighs the benefit. The Church recognizes that a refusal to begin or continue excessively burdensome treatment is not the same as suicide. On the contrary, such a decision is considered an acceptance of the human condition, a wish to avoid treatment that is out of proportion to the expected results, or a desire not to impose unnecessary agony and burden on the patient, family or even the community.

Finally, the Church teaches that it is very important to protect at the moment of death both the dignity of the human person and the Christian concept of life.

This Web site cannot answer all the difficult questions that you might have about making medical choices, or about choosing someone to make choices for you in the event you cannot do so yourself. You should discuss these matters with your family, physician, priest, minister, rabbi or other counselor.

Advanced Directives \| Brochures \| Cancer Screening Download \| Education \| Emotions and Cancer \| Glossary of Terms \| Patient Rights \| PowerPoint Presentations \| Understanding Cancer \| Videos		JACC 4101 22nd Place Lubbock, Texas 79410 phone: 806-725-8000 fax: 806-723-6412 General Information: info@joearrington.org
Advanced Directives
Downloads: Advanced Directives PDF and Medical Power of Attorney PDF There may come a time when you or a member of your family becomes seriously injured or critically ill. Grief and shock may dominate your emotions, affecting your ability to make important medical decisions. These decisions include whether to withdraw “life-sustaining” treatment, who should make such decisions in the event that you are unable, and whether your organs should be donated in the event of your death. Advanced Directives are legal documents that tell your doctor your wishes about medical treatment when you are unable to communicate these decisions or choices yourself. Generally, these documents are signed in advance of treatment to let your doctors and healthcare team know your wishes. For example, if you fell into a coma, they would let the doctor know your wishes for care or say whom you would wish to make the decisions for your care. Advance directives are not required for admission to Covenant Health System or if you are under treatment at Joe Arrington Cancer Research or Treatment Center, but we strongly recommend that you have these documents in place. Our patient representatives can provide you the forms and instructions for having them completed so they are legally binding. Our chaplains will be more than happy to assist you in filling out the documents correctly. It is important that you discuss your wishes with your loved ones so they will respect these documents if they are called into use, especially if you are naming someone to act on your behalf. Make sure you give copies of these directives to your family, doctors and any healthcare facilities where you receive treatment. You can change your mind any time after creating these directives–simply destroy the original and let your family, doctor and anyone else with copies know of your change of mind. These directives only go into effect when you are no longer able to make your own healthcare decisions (no longer able to provide informed consent). These advance directives will be placed in your hospital chart, but it is important that you make your healthcare providers aware that you have made advance directives. If you do not make any advance directives, there is a chance you may receive life-prolonging procedures that you might not wish to have. If you have no advance directives, your healthcare providers will look to others to make life-prolonging care decisions in the following order: Your guardian, if the court has appointed one, or a healthcare surrogate you have appointed Your spouse An adult child (if you have more than one, the doctor will seek opinions from all who are reasonably available to consult) Either of your parents An adult sibling, or if you have more than one, the doctor will seek opinions from all who are reasonably available to consult Any other of your adult relatives who have shown special care or concern for you, and who are familiar with your activities, health, religious or moral beliefs.
Advanced Directives FAQ
*Q: Why should I be concerned about making advance directives for my healthcare?* A: Accidents happen to people of all ages. You could suddenly become incapacitated by an accident or illness, or by a condition that could gradually (or sometimes quickly) lead to your loss of decision-making capabilities. Q: Do I have a right to direct my care? A: Whether you are conscious and able to communicate, or unconscious and unable to communicate, you have two basic rights regarding medical treatment. First, you have the right to have the situation clearly explained to you or your surrogate. Second, you have the right to decide what healthcare you will receive, or will refuse. This does not mean a doctor or a hospital must follow your instruction if they believe it is seriously wrong. They may notify you that they are unwilling to abide by your instruction. If you insist, it is the physician’s responsibility to find doctors and a hospital that will agree to follow your instruction. *Q: What information do I need to make good healthcare decisions?* A: In order to make a reasonable decision, you have a right to the following kinds of information: Your doctor’s diagnosis and prognosis of your medical condition. What tests might determine the causes, or possible causes of your condition? What treatment alternatives are available, including experimental or risky treatments that might be helpful? What risks and benefits are involved in the different treatments? What are the consequences of not having treatment? What does your doctor recommend? What are the expected costs and other burdens of proposed tests and treatment? Q: How can I influence my care if I am unable to decide for myself or I am unable to communicate? A: It is important you communicate clearly, in advance, what you would want if you should become unable to make or communicate decisions. In such situations, your reasonable directives should be followed if they are known. In an emergency (and unless they know you would refuse care), healthcare professionals will do what they believe is necessary to save your life or prevent serious injury if you are unconscious. For adults, healthcare professionals will in many circumstances accept the reasonable directions of a spouse, an adult child or a surrogate. When the family disagrees, either someone in the family or the healthcare provider may ask a court to appoint a legal guardian to make decisions for you. For children, parents or a guardian usually make decisions about treatment. Q: How can I communicate my wishes regarding healthcare? A: There are two major instruments that can be executed under Texas law in order to have a person’s desires regarding medical treatment made known, in the event that the person is later unable to make such decisions. The first is the Directive to Physicians under the Texas Natural Death Act. This is also known as the “living will.” It allows a person to tell physicians to withhold or withdraw life-sustaining procedures in the event of a terminal condition. It also allows a person to designate another individual to make treatment decisions if the person becomes comatose or incompetent (mentally or physically incapable of communication). The second instrument is the Medical Power of Attorney. This special power of attorney allows a person to appoint an individual, and as many alternates as desired, who will be authorized to make any healthcare decision on behalf of the person granting the power of attorney (called the Principal), if the person (i.e., Principal) later lacks the capacity to make healthcare decisions for himself or herself. This allows a person to select, in advance, those persons he or she would want to make healthcare decisions in the event he or she later becomes incompetent. Q: Does the Church offer guidance for making treatment decisions? A: The Church, both Roman Catholic and United Methodist, teaches that all life comes from God and that all human beings are created in the image and likeness of God. This gives human life its special meaning. But, Church teaching also recognizes that death is an inevitable part of life and is a transition to eternal life. Church tradition also recognizes and respects reasonable individual autonomy - the right and responsibility of each person to make reasonable treatment choices. This includes choices to refuse or to discontinue life-sustaining treatment that is ineffective and/or overly burdensome. It is ethically acceptable to discontinue medical treatment when the burden of the treatment outweighs the benefit. The Church recognizes that a refusal to begin or continue excessively burdensome treatment is not the same as suicide. On the contrary, such a decision is considered an acceptance of the human condition, a wish to avoid treatment that is out of proportion to the expected results, or a desire not to impose unnecessary agony and burden on the patient, family or even the community. Finally, the Church teaches that it is very important to protect at the moment of death both the dignity of the human person and the Christian concept of life. This Web site cannot answer all the difficult questions that you might have about making medical choices, or about choosing someone to make choices for you in the event you cannot do so yourself. You should discuss these matters with your family, physician, priest, minister, rabbi or other counselor.