Health Care Decisions & Advance Directives
Tools for Decision Making
A list of questions that can help you think about your values as they relate to medical care decisions. You may use the questions to discuss your views with your health care agent and others, or you may write answers to the questions as a help to your agent and health care team.
When you make medical decisions for someone else, you are acting as a health care proxy — which is the general term used for a person who makes decisions for someone else.
A starter kit to help you organize your thoughts and talk to your loved ones about end-of-life care.
A tool kit for talking with your doctor and/or health care team to make sure they know your preferences regarding end-of-life care.
A resource to help start conversations about how we want to be cared for at the end of our lives.
A workbook to help patients understand and communicate their own questions, concerns and priorities so they can become more effective partners in their own care.
A reminder of things that might be good to check on as you plan and fill out an Advance Directive.
As a proxy, you may need to decide whether the person should have a Do Not Resuscitate (“DNR”) order or Clinician Orders for Life-Sustaining Treatment (“COLST”). These are medical orders signed by a doctor that tell everyone — including first responders — not to use specific procedures and treatments on the person. They are powerful tools for ensuring that a person’s wishes to limit treatment are honored, because they are binding on all medical personnel. They can be used for a person who is at home, in a nursing home, or in a hospital. If there are specific procedures or treatments you know or think the person would not want, talk with the doctor about having a DNR or COLST order written.
A DNR is a doctor’s order telling medical personnel not to perform CPR on the person. If you are health care proxy for a person who would not want CPR under any circumstances, or if the person’s wishes are unknown but you believe that using CPR would not be in the person’s best interests, a doctor must write a DNR order saying not to use it. Ask the doctor about the likely outcome of CPR for the patient, and about pain, discomfort or side effects the procedure might have. This may help you decide.
COLST Orders — Clinician Orders for Life Sustaining Treatment
A COLST is more comprehensive than a DNR order, covering orders for treatment such as intubation, mechanical ventilation, transfer to hospital, antibiotics, artificially administered nutrition, or another medical intervention. It can be used in outpatient settings and health care facilities and may include a DNR order. If you are proxy for a person who would not want to have some or any of these treatments, or who would not want to be taken to a hospital if 911 was called, talk with the doctor about completing a COLST form.