While the primary hope of hospitals is to improve and save people’s lives, each day hospitals all over the country help patients and their families deal with end-of-life decisions for their loved ones. Even at Lancaster General Hospital, we sometimes need to assist in these types of difficult situations.
Bob Macina, Senior Vice President and General Counsel, says that one way you can help yourself and your family is by having an advance directive so that your wishes for medical care are known and to enable those close to you to make decisions on your behalf.
An advance medical directive is a document that you complete in advance of your need for healthcare, expressing your wishes for future medical services. Bob explains that there are two primary types of advance medical directives, living wills (declarations) and durable powers of attorney.
Your living will becomes operative if your attending physician determines you are either in a terminal condition or a permanent state of unconsciousness and you are also incapable of participating meaningfully in medical decisions.
A durable power of attorney (POA) is a written document that assigns decision-making powers to a person you select. With your POA, you may specifically delegate healthcare decision-making powers.
“The differences between a POA and living will are that a POA merely appoints a substitute decision-maker and gives that person broad powers, such as the ability to admit you to a nursing home and submit your healthcare claims,” Bob explains. “A living will is effective only if you are in a terminal condition or permanent state of unconsciousness.”
If you have an advance directive, give copies to your family doctor, specialists, hospital and family members. And know that even when you have an advance directive, if you are competent and can communicate with your physician, you can continue to direct your care.
“The presence of an advance directive is not a guarantee that the care of a patient will be free from controversy, but it is likely to go a long way in removing any uncertainty about a patient’s wishes in end-of-life situations,” Bob says.