MEDICAL SURFARI: WHO DECIDES ISSUES OF OUR HEALTH CARE?

It can happen to you.

Cancer. A heart attack. Stroke. A slip in the bathtub. A car accident where you are rushed to the hospital

When you need medical care, you want the best that you can get. The advancement of medical technology has brought about more choices for patients and physicians. This is especially true when patients have critical injuries or illnesses that threaten their life. As you know, there are now a variety of instruments and devices, "machines" that are available to physicians and patients at different stages of illness, injury and disease. Most of the time it is clear when to apply these technologies for patients. Sometimes, however, there are real dilemmas and we are confronted with making life or death health care decisions.

Remember, every lucid adult has the right to make choices about available health care treatment options. In fact, there are several ways that you can make certain that your health care wishes will be carried out on your behalf, even when you are unable to make treatment decisions yourself. You can do this by preparing an advance directive, which is a legal document that can be prepared with or without the assistance of an attorney. This will allow you to decide in advance what medical treatment you want to receive if you become physically or mentally unable to communicate your wishes.

There are two common types of advance directives: a living will and a durable power of attorney for health care.

A living will is a written document that states the kind of medical care that you want or do not want if you become unable to make your own decisions. It is called a living will because it takes effect while you are still living as opposed to estate wills which take effect after you die.

A durable power of attorney for health care (DPAHC) authorizes someone else, a proxy, to make your medical decisions if you are unable to make them for yourself. This can also include instructions about treatments that you do not want.

You may be in a quandary about which of these directives is better.

Remember that a living will doesn't allow you to name someone to make your medical decisions if you cannot, but a durable power of attorney for health care does. Remember, you do not have to have any type of advance directive if you do not want one; however, if you have one be certain to tell your family, close friends, and minister about your wishes and where your advance directive is located. Also, tell your attorney and physician and make certain that your advanced directive is part of your medical records where you are likely to receive your care. If you have a DPAHC, be sure to give an original copy to the person that you have named as your proxy. Keep a small card in your purse or wallet that notifies emergency medical services of your wishes because most of the time in an emergency situation, there is no time to look for or evaluate different types of documentation. So, make certain that those who are likely to be called in the a health emergency know whether or not you have an advance directive.

Some people wonder whether they need a lawyer to do an advance directive. Technically this is not necessary, however, a lawyer is a helpful resource. He or she can confirm that you have completed the necessary steps and have done them well to assure that your wishes are carried out properly.

Remember, it is only a matter of time and probability before we all face these difficult issues and decisions. Help those close to you by giving them some guidance on your personal values when it comes to issues like cardiopulmonary resuscitation, artificial nutrition and hydration, respirators (breathing machines), kidney dialysis and medications. When you create your advance directive let your values and attitudes be your guide and discuss them with loved ones or advisers before making your final decisions.

Your community hospital is your best resource for accessing health care advance directive documents.

WORLD WIDE WEB RESOURCES

ElderWeb

www.elder.com/addirect.htm

ElderWeb provides a wonderful array of consumer information on advance directives. You can even access information specific to Missouri and Illinois laws governing living wills and durable power of attorneys.

American Association of Retired Persons (AARP)

www.aarp.org/programs/advdir/adiraarp.html

The AARP supports the concept of planning medical decision-making through the use of advance directives, and provides information on advance directives that is pertinent to persons of all ages.