| Advance Directives |
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| Advance Directives Information |
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An advance
directive is a set of instructions that explain the
specific health care measures a person wants if he or she should
have a terminal illness or injury and become incapable of indicating
whether to continue curative and life-sustaining treatment,
or to remove life support systems. The person must develop
the advance directive while he or she is able to clearly and
definitively express him or herself verbally, in writing, or
in sign language. It must express the person's own free will
regarding their health care, not the will of anyone else. It
does not affect routine care for cleanliness and comfort, which
must be given whether or not there is an advance directive.
In Oregon, the Health Care Decisions Act (ORS
127.505 - 127.660 and ORS 127.995) allows an individual
to preauthorize health care representatives to allow the natural
dying process if he or she is medically confirmed to be in
one of the conditions described in his or her health care instructions.
This Act does not authorize euthanasia, assisted suicide or
any overt action to end the person's life. To print an advanced directive
form.
Requirements
Witnesses: Two
adults, at least one of them not related to the person by blood
or marriage nor entitled to any portion of the person's estate,
must witness or acknowledge the person's signing the advance directive.
The person's attending physician, attorney-in-fact, and health
care or residential staff may not serve as witnesses.
Health Care Instructions: These
may either be general, or relate to the four specific conditions
outlined below. However, general instructions, such as the person
never wishes to be placed on life support, may be too vague and
not provide for a situation in which an accident or emergency requires
that the person be placed on life support temporarily. Specific
instructions regarding the person's wishes in each of the four
scenarios listed below are preferred. Some hospitals' social workers
or chaplains will provide instructions and forms for advance directives.
The patient's physician can determine whether any of these four
conditions apply:
- Close to death: Terminal illness
in which death is imminent with or without treatment, and where
life support will only postpone the moment of death.
- Permanently unconscious: Completely
lacking an awareness of self and external environment, with no
reasonable possibility of a return to a conscious state.
- Advanced progressive illness: A
progressive illness that will be fatal and is unlikely to improve.
- Extraordinary suffering: Illness
or condition in which life support will not improve the person's
medical condition and would cause the person permanent and severe
pain.
Options
Health Care Representative: An advance
directive can appoint someone who is at least 18 years of age to
make medical decisions for the person when that individual is not
able to do so. Among the decisions this health care representative
can make is whether to withhold or remove life support, food or
hydration. The health care representative and an alternate must
sign the document, accepting their appointment. The patient should
appoint a health care representative that he or she trusts completely.
A patient can voluntarily revoke their appointment of a health
care representative at any time. A general Durable Power of Attorney,
which is for financial affairs, does not include authority to make
health care decisions.
Special instructions and conditions: These
can be inserted into the Health Care Plan or included for the health
care representative as long as they don't deal with the distribution
of property.
Duration and changes: The advance
directive can be designated in effect for a limited period of time.
If not, it is in effect until the person revokes it in writing,
or dies. A person can cross out words or add words to his or her
advance directive to make it better express his or her wishes.
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