Protecting Your Rights With Advanced Directives
...variety of documents to protect patient’s rights. These are known as Advanced Directives. These documents allow patients to state what treatments they want and the ones they do not. In the State of Texas, the most commonly used forms are The Power of Attorney, Directive to Physician and Family or Surrogates, Do Not Resuscitate and The Declaration for Mental Health Treatment. Advanced Directives can be changed at any time, as long as the patient has not been found incompetent. The Medical Power of Attorney allows the patient to choose a proxy to make medical decisions on the behalf when they can no longer do so for themselves (Burkhardt & Nathaniel, 2002). The proxy can then make decisions for the patient about health care, including topics such as life support. The patient generally chooses someone that they can trust to follow their wishes. This document only goes into effect until the physician certifies that the patient can no longer make these decisions. The Directive to Physicians and Family or Surrogates is also known as the Living Will (Burkhardt & Nathaniel, 2002). These are used when someone has been diagnosed with a terminal disease or a condition that cannot be reversed, such as a cerebrovascular accident or Alzheimer’s. The patient could put in writing whether or not they want to receive every possible medical treatment to save their life. As with the Medical Power of Attorney, The Texas Directive to Physicians and Family or Surrogates only goes into effect when the physician certifies that the patient is unable to express their own wishes. Living Wills are not considered legal documents. Patients can only hope that the physician and facility will honor it. The Do Not Resuscitate Order is better known as DNR. This is by far the most popular one. According to Darr (1999), patients can now state whether they want to be resuscitated or not. Resuscitative efforts begin when someone’s heart stops beating, or they stop breathing. Patients who sign a DNR are turning down life saving measures such as cardiopulmonary resuscitation, transcutaneous pacing, defibrillation, ventilation, and advanced airway management. They are not turning down the right for surgery or anesthesia to help with the quality of life. Another type of a DNR is the Out of Home DNR or EMS-DNR. This type of DNR is for terminally ill patients who are not in the hospital setting. Emergency medical service is bound by law to perform CPR. This document releases the emergency medical services from that law (Darr, 1999). The Declaration for Mental Health Treatment allows patient to make decisions about mental health treatment. According to Patterson (2002), this advanced directive would have this on file before the person became mentally incompetent. After the patient has been classified as incapacitated, the Advanced Directive cannot be changed. This directive is used to state before hand what treatment the patient wants or does not want. For example, someone with a bipolar or schizophrenic disorder might refuse treatment during an episode of mental disturbance (Patterson, 2002). With this Advanced Directive, physicians can feel better about treating the patient if they know the patient had previously agreed to it. According to Tammelleo (2000), following a patient’s wishes can be hard. The Advanced Directive could be either too broad or not clear enough to follow. The patient’s proxy may not follow the patient’s wishes as the patient comes closer to death. Family members may believe that the patient may have actually wanted something other than what was stated. Health care professionals are sued...