Your Stay at GVH
Advance Directives in Pennsylvania
Your Right to Make Decisions Affecting Your Care
Grand View Hospital honors your right to make decisions regarding your health care.We encourage you to think in advance about
what treatment you would accept or refuse if you were to become terminally ill or permanently unconscious, and could not express your wishes. One way to make sure your wishes would be followed in such an event is to have written instructions, called advance directives, that explain what kind of treatment you would want. Two types of advance directives related to health-care choices are recognized in Pennsylvania: living wills and power of attorney for health-care decisions. They are legal documents that enable health-care personnel to obtain information about your wishes should you not be able to communicate. Usually, they are written in advance of serious illness and state your choices for health care, or name someone to make those choices if you become unable to make decisions.
Types of Advance Directives in Pennsylvania
- Living Will
A legal paper that spells out the kind of life-prolonging medical care you would want – or would not want – if you were to become terminally ill or permanently unconscious and unable to make your own decisions.
- Power of Attorney for Health-Care Decisions
A signed and dated document that gives another person the legal right to make decisions regarding your health care if you are not able to make such decisions yourself. This person will have access to your medical records.
While it may be a good idea to have both a living will and a power of attorney for health-care decisions, you do not need to have either of these documents. If you want to designate specific treatment that you do or do not want, you may want to write a living will, even if you have named someone (an agent) to make decisions for you. Pennsylvania courts have not decided if the law permits an agent to refuse treatment on your behalf.
You may revoke an advance directive at any time. Any changes or revocations should be signed and dated and you should give
copies to your family and doctor.
Advance Directices Go Into Effect Only Under Certain Conditions
It is important to know that an advance directive goes into effect when you are in our hospital only if Grand View has a copy of it. Please bring a copy of your advance directive with you every time you are admitted to Grand View. Also, give copies of your advance directive to your doctor and loved ones so your wishes would be known should you be admitted to the hospital unexpectedly.
Additionally, for a living will to go into effect:
- Your doctor must determine that you have a terminal medical condition or are in a state of permanent unconsciousness.
- Your doctor, and a second doctor, must determine that you are incompetent to make medical decisions.
A power of attorney for health-care decisions goes into effect only when you are unable to make health care decisions for yourself. Conditions that might prevent you from being able to make decisions for yourself include the effects of anesthesia or other medication, a state of unconsciousness (either temporary or permanent) and serious illness or injury.
Advantages of Having an Advance Directive
An advance directive:
- Helps protect your right to make medical choices that can affect your life.
- Allows your family to know and understand your wishes.
- Gives physicians and other health-care workers involved in your care guidelines regarding the care you want to receive.
- Allows you to give special directions to your health-care providers on topics, such as pain relief.
- Enables you to indicate your desire to forego certain life-prolonging treatment, i.e., breathing machines, feeding tubes, or dialysis, when there is little or no chance of recovery.
Grand View's Responsibilities
Grand View and other health-care providers must provide necessary medical care to all individuals in their care.We are relieved of this duty only if we can show that the care goes against a person’s wishes. An advance directive is one way we can show that we are following your instructions.Your decision to either have – or not have – an advance directive in no way affects the care you receive at Grand View.
Federal law requires Grand View and other hospitals to ask you upon admission whether you have a living will or power of attorney. We will document your answer in your medical record. If you have an advance directive, please bring a copy with you. At Grand View, your advance directive is viewed as a statement of your wishes and is used by the attending physician in determining your treatment plan.
If you do not have an advanced directive and are interested in making one, we will provide you with the opportunity to speak with individuals who can help you, such as a case manager, nursing supervisor or chaplain. These individuals have examples of advance directives. Examples may also be available through your doctor, your county bar association, your county Area Agency on Aging office or your local chapter of the American Association of Retired Persons. The law requiring hospitals to ask patients about living wills applies to adult patients.
People You May Want to Involce When Creating Advance Directives
It is a good idea to talk with your doctor about the risks and benefits of any medical procedure or course of treatment that your physician recommends. Ask about possible side effects and any alternatives to the proposed procedure or course of treatment. You may accept or reject your doctor’s advice, and you may seek a second opinion.
Once you have made your decisions about what instructions to include in your advance directive, it is important to talk with your doctor to make sure your physician is comfortable in following your wishes. Likewise, it is a good idea to make sure the person you have given permission to make decisions on your behalf is willing to follow your wishes.
If you tell your physician or your family members about the health care you want to accept or refuse, but do not put your instructions in writing, your wishes will sometimes be followed by health-care providers, depending on how detailed and recent these instructions are. If you want to be certain your wishes are followed, it is best to put them in writing.
Give a copy of your advance directive to your family doctor, lawyer and family and to those people you have named to make
decisions for you if you are unable to make them.You also should bring a copy with you every time when you are being admitted to a hospital, nursing home or other health-care facility.You should review your advance directive periodically to make sure your wishes have not changed. Make sure that when there are changes to your advance directive, all old copies are destroyed.
Although you do not need an attorney to draw up advance directives, lawyers may know best how to advise you regarding some
legal rules that apply to power of attorney for health-care decisions.
Grand View Policies Related to Advance Directives
Grand View has several policies in place to protect your rights to accept or refuse care. They involve issues related to efforts to support vital bodily functions, such as breathing, the beating of your heart, hydration and nutritional intake. Another policy also specifies the donation of organs or tissues.
The Grand View Ethics Committee is available to help families resolve any conflicts related to your care. Please talk to your nurse if you would like to consult with a member of the Ethics Committee.
If you do not have an advance directive and are interested in creating one, please contact a representative of our Case Management Department by calling:
215-453-4487 (Dial 4487 within the hospital.)
The nursing supervisor and chaplain are also available to assist you.To reach either of them, please contact the operator, who will connect you to or page the nursing supervisor or chaplain.
215-453-4000 (Dial 0 within the hospital.)
Glossary
You may encounter some of the terms below as you make choices regarding advance directives.
Incompetent
The lack of sufficient capacity for a person to make or communicate decisions related to care options either due to physical
or mental impairment.
Permanently Unconscious
A condition in which a patient is determined to be in a state of total loss of consciousness that cannot be reversed.
Terminal Condition
An incurable and irreversible medical condition in an advanced state that will result in death.
Life-Sustaining Treatment
A medical intervention given to a patient that prolongs life and delays death.
Cardiopulmonary Resuscitation (CPR)
A method used to restore stopped breathing and/or heartbeat.
Respirators
Machines used to assist or keep a patient breathing.
Feeding Tubes
Tubes inserted through the nose, mouth, stomach, etc., to feed patients who are no longer capable of eating normally.
Intravenous (IV) Therapy
A treatment method that provides nutrition and water and/or medication through a thin tube placed in a vein.
Brain Death
Complete stopping of all function of the brain that cannot be reversed. A brain-dead person is not in a coma, but is, in fact, dead.
Do Not Resuscitate (DNR)
A doctor’s order that alerts other health-care givers that the patient or family, in consultation with the doctor, does not want the patient to be given CPR.
Surrogate
The appointment of another person to act on your behalf. May also be referred to as agent.
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