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Vermont
Ethics Network
Frequently
Asked Questions
about Choices in Medical Care
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The
answers to these questions are taken from the booklet "Taking
Steps to Plan for Critical Health Care
Decisions" published by the
Vermont Ethics Network. For information on this and other VEN's
publications and how to purchase them click
here.
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Click
for the answer:
- Why should I write an Advance Directive?
- Who can write an Advance Directive?
- Who should consider preparing an advance directive?
- Who can be my agent?
- Is my doctor required to honor my advanced directive?
- Will another state honor my advanced directive?
- Will my advanced directive be honored in an emergency?
- Can I still make my own health care decisions if I have signed an Advance Directive?
- Is an Advance Directive useful only for refusing treatment?
- What if I change my mind about the kind of treatment I want?
- What should I do with my Advance Directive document after I have signed it?
- How can I become an organ donor?
- Does my Advance Directive authorize my agent to make funeral arrangements for me?
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Why should I write an Advance Directive? There may come a time when you are seriously ill or injured and cannot make your own decisions about what kinds of life-sustaining treatment you would want under the circumstances. By having discussed these matters ahead of time with loved ones and then appointing an agent to make medical decisions for you, based upon your values and wishes, you will give your loved ones a beacon to guide them through a most difficult time. It will be a gift of communication and an assurance that your wishes are being honored. .
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Who can write an Advance Directive? You may write one if you are an adult (the Terminal Care Document specifies that you be at least 18) and are capable of understanding the nature and consequences of your medical care decision.
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Who should consider preparing an advance directive? Everyone who qualifies. No matter how young or old, how healthy or sick you are, you could have an accident or unexpected illness and suddenly be unable to speak for yourself.
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Who can be my agent? Anyone over 18 years old or older can serve as your agent, with one exception. Under Vermont law, your health or residential care provider cannot be your agent and your provider at the same time - unless that person is a relative. Vermont law also allows for selection of an "alternate agent," in the event your agent is unavailable when a health care decision is required.
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Is my doctor required to honor my advanced directive? Your doctor is legally required to follow its directions as closely as possible. If your doctor disagrees with your wishes, he or she must help find another physician willing to follow your instructions. That applies to all the doctors involved in your care.
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Will another state honor my advanced directive? Most states will honor an out-of-state advance directive, but some require that it conform to their own laws. New Hampshire, for example, does not permit artificially supplied nutrition and fluids, tube feeing, to be withheld or withdrawn unless the patient has provided written instructions to that effect in an Advance Directive. Unlike Vermont, New Hampshire also requires that advance directives be notarized.
Some states will not honor an advance directive of a patient who is pregnant and permanently ill or comatose. While Vermont has no such law, women capable of becoming pregnant should consider including instructions relating to pregnancy on their advance directives.
If you are expecting to be treated out-of-state, check directly with the state or contact the National Hospice and Palliative Care Organization (www.nhpco.org) , 1700 Diagonal Road, Suite 625, Alexandria, VA, 22314 (telephone 1-800-658-8898 ), for more information or to view the forms of the other state. It is a good idea to take a photocopy of your advance directive with you when you travel. You may also carry a wallet card.
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Will my advanced directive be honored in an emergency? If you have a medical emergency outside of a hospital, the ambulance crew is instructed to give you life-prolonging care until you can get to the hospital and are evaluated by a doctor. At the hospital, you, or your advance directive, can guide further decisions. If you are terminally ill and wish to die at home, you should talk to your doctor, other caregivers and family members about situations in which you might or might not want the ambulance summoned.
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Can I still make my own health care decisions if I have signed an Advance Directive? Absolutely. You continue to make your own medical decisions as long as you are able to do so and can communicate your wishes. Your agent's authority begins only when you lack the capacity to make your own decisions, as certified in writing by your doctor. Even if your agent has already begun to make decisions on your behalf, treatment cannot be given or withheld if you object.
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Is an Advance Directive useful only for refusing treatment? No. One of the strongest features of an Advance Directive is that it enables you to indicate the kind of care you do want as well as treatments you don't want.
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What if I change my mind about the kind of treatment I want? You must fill out a new form if you want to change anything in your written advance directive. Writing a new Advance Directive automatically cancels the old one. You may also cancel an Advance Directive by tearing it up or telling others that it no longer applies. Be sure to notify everyone who has copies of your advance directive that you are canceling it and writing a new one.
It is also important to review your advance directive every few years, more often if your health is declining, to make sure it still reflects your wishes. Initial and date it each time.
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What should I do with my Advance Directive document after I have signed it? There are no specific legal requirements, but copies should be given to your family, your doctor and your local hospital. You may also carry a wallet card.
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How can I become an organ donor? If you are at least 18 years of age, you may sign and carry a Uniform Donor Card. (Download Card). You may also check and sign the appropriate lines on the back of your Vermont Drivers license. These cards authorize the removal and use of your organs and tissue after your death. Organs needed for transplantation are kidneys, lungs, heart, liver and pancreas. Tissues used for transplantation include eyes/corneas, bone and associated connective tissue, skin, heart valves and cardiovascular tissue. The new Advance Directive for Health Care Form has a special optional section for you to express your wishes about being an organ donor. More Details on Organ Donation.
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Does my Advance Directive authorize my agent to make funeral arrangements for me? Yes, it can if you wish. Part Four allows you to share specific directions about your funeral wishes or other disposition of your remains, including who you wish to name as your agent for this purpose. It may be somebody other than your health care agent. Or, you may just want to indicate that your family will decide. |
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