Documents give patients the right to decide
Staff reporter
Decisions related to dying with dignity is not just an elderly person's issue.
The recent death of Terri Schiavo, a 41-year-old woman who was in a vegetative state for 15 years, resonates that a medical condition or accident can debilitate anyone at any age and may require life-sustaining decisions.
"The Natural Death Act," a Kansas statute, allows a person to make a written declaration instructing a physician to withhold or withdraw life-prolonging measures in the event of a terminal condition.
A "living will" can be signed by any competent person who is at least 18 years of age but does not become effective until an attending physician diagnoses a terminal condition.
The Patient Self-Determination Act is a federal law that requires hospitals to provide written information to adult in-patients concerning an individual's right to make decisions concerning medical care.
Patients admitted at St. Luke Hospital are asked if they have a living will.
If the patient does not have a living will and wants one, the hospital has forms available.
"We also answer questions about a living will and durable power of attorney for health care," said Linda Kannady, RN, acting chief nursing officer.
She said the hospital has not noticed an increase in living wills since the Schiavo case has made headlines but anticipates renewed interest.
"This is something everyone should have in place," Kannady said.
An individual may complete a simple form or consult with an attorney regarding the document.
Documents may vary but all declare a person's wishes regarding quality of life and artificially prolonging it if an incurable injury, disease, or illness is diagnosed.
The condition or injury must be certified a terminal condition by two physicians who have examined the individual. One must be the patient's personal physician.
These physicians will determine that death will occur whether or not life-sustaining procedures are utilized, and application of life-sustaining procedures would only serve to artificially prolong the dying process.
Administration of medication or the performance of any medical procedure deemed necessary will be provided to the patient for comfort care.
The document would be used if the individual is personally unable to give these directions.
The will must be signed by the individual, and two witnesses, or notarized. It is recommended to have the document signed by witnesses and notarized.
A person can add a time line for making this decision such as "within 72 hours of the initial onset" life-prolonging procedures may be withheld or define "quality of life."
Procedures on the document include surgery, heart-lung resuscitation (CPR), antibiotics, mechanical ventilator (respirator), dialysis, and feeding tubes.
There also is a space available for a person to describe an acceptable quality of life.
The will can be revoked or changed at any time.
It also is recommended to appoint a durable power of attorney for health care decisions.
The form designates an individual to make the necessary decisions if and when a person is unable to do so. The POA can consent, refuse consent, or withdraw consent to any care, treatment, service, or procedure to maintain, diagnose, or treat a physical or mental condition.
The POA also can make decisions about organ donation, autopsy, and disposition of the body.
Limitations may be set on the POA and should be spelled out on the form.
The form must be signed by the individual who is designating the power of attorney, and two witnesses or a notary. Again, it is recommended two witnesses and a notary sign the document.
Like a living will this document also may be revoked or changed at any time.
Forms are available at Marion Senior Center and various Internet web sites.
It always is advisable to consult an attorney before signing any documents, especially those not self-generated.
It is a person's right to choose to establish advance directives.
Regardless of the choice, it is advisable to share this information with family members and physician.
