Advance Care Planning

Advance Directives and Durable Power of Attorney for Health Care

Making Health Care Decisions

As a competent adult, you have the right to accept or refuse any medical treatment. "Competent" means you have the ability to understand your medical condition, weigh the possible benefits and risk of treatment and then decide if you want to accept treatment. Only you can say "yes" or "no" to any treatment offered. You can say "no" to treatment even if the treatment you refuse might keep you alive longer and even if others want you to have the treatment.

Someday, you may become too sick to make your own decisions about medical care. If that happens, then decisions will need to be made for you. If you have not given any instructions, no one will know what you would have wanted.

Following are answers to several commonly asked questions about Advance Directives and Durable Power of Attorney for Health Care, which we hope will help you to understand your rights.

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Frequently Asked Questions

The Patient Advocate Designation Form does require the signature of two witnesses. The law excludes some people from signing as a witness. Your spouse, parents, children, grandchildren, sisters or brothers may not sign as a witness. Anyone named in your will may not be a witness on the document. Employees of the life and health insurance companies that insure you may not be a witness. Finally, the law disqualifies the person you name as your advocate, your doctor and all employees of the facility or agency providing health care from witnessing the documents. Friends and co-workers are good people to ask to be witnesses since they know you and can attest that you are acting voluntarily.

Treatment decisions are difficult. We encourage you to think about them in advance and discuss them with your family, friends, and caregivers. You can and should ask your facility or agency about their treatment policies and procedures and to be sure you understand them and how they work.

A Durable Power of Attorney for Health Care is a document you complete to name someone to make medical decisions for you if you are unable to make decisions yourself. This person is called your Patient Advocate. This document must include an "Acceptance of Patient Advocate" section where the person you choose acknowledges they are willing to serve as your advocate. If you want your Patient Advocate to make the decision to refuse any treatment and allow you to die, you must specifically state this in the Durable Power of Attorney for Health Care form.

Advance Directives are documents you sign as a competent person giving directions to health care providers about treatment choices in certain circumstances. There are two parts of an Advance Directive - a listing of your health care wishes (your directives) and the Durable Power of Attorney for Health Care which is explained below.

Sometimes the terms "Advanced Directives" and "Living Wills" are used interchangeably. A "Living Will" is a limited type of Advance Directive that may be used if you are terminally ill or in a permanent vegetative state. The state of Michigan does not legally recognize a "Living Will, " but courts and health care providers find this type of document useful as a guide to your wishes.

You may obtain sample forms from the Admitting Department or Case Management. Forms are also available from the State Bar of Michigan, the Michigan State Medical Society, your state representative, and senior citizen groups. Not all forms are alike so you should choose one that meets your needs. Legal advice is not required to complete the forms, but if you wish, your attorney can also help you prepare a document. You should talk to the person you have chosen as your Patient Advocate to make sure that individual understands your wishes and is willing to act as your advocate. We also urge you to discuss your wishes with your family, friends, and health care team. Make sure a copy of your forms is given to all your health care providers.

Many people have strong feelings about the kind of medical care they would like to receive or refuse in certain circumstances. An Advance Directive allows you to clearly state your feelings. Below are some things to think about when developing your Advance Directive.

Who would you like to make treatment decisions for you, if you become unable to do so?
How do you feel about ventilators, surgery, resuscitation (CPR), drugs or tube feeding if you were to become terminally ill? if you were unconscious and not likely to wake up? If you were senile?
What kind of medical treatment would you want if you had a severe stroke or other medical condition that made you dependent on others for all your care?
What sort of mental, physical, or social abilities are important for you to enjoy living?
Do you want to receive every treatment your caregivers recommend?

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