When you or a family member becomes seriously injured or sick, grief and shock can cloud the decisions you make. Questions about the intensity of medical care administered and whether life support systems should be used or withdrawn are important ones that should be answered before a crisis situation happens.
It is important for you and your family to learn about the types of medical care available and to discuss the kinds of treatment with which you would feel comfortable.
Advance Directive for Healthcare
An Advance Directive allows you to give healthcare instructions and appoint a healthcare agent to carry them out should you become incapable of expressing your own wishes. You can make decisions about the future use of life-sustaining procedures in the event you have a terminal condition, if you are in a persistent vegetative state or if you have an end-stage condition. You may also choose to use an Advance Directive to make other healthcare decisions.
The Patient Self-Determination Act, a federal law, and The Healthcare Decision Act, a Maryland law, provide that you have the right to make healthcare decisions in advance through a document called an Advance Directive For Healthcare. There are two types of written directives regarding future healthcare decisions: An Advance Directive and a Living Will.
If you would like more information regarding an Advance Directive For Healthcare or a Living Will, please contact the Pastoral Care Department at 410-543-7157 between 8:00 am and 4:00 pm, Monday through Friday. At all other times, dial “0” and ask for the on-call chaplain.
Delaware and federal law give every competent adult, 18 years or older, the right to make their own healthcare decisions, including the right to decide what medical care or treatments to accept, reject or discontinue. Delaware law recognizes two types of Advance Directives: Instructions for Health Care (Living Will) and Power of Attorney for Health Care.
In Delaware, the Advance Directive must be in writing, signed by you or by another person at your direction in your presence, dated and signed in the presence of two qualifying witnesses.
The following people CANNOT witness your advance directive:
- Anyone related to you by blood or marriage
- Anyone who is entitled to a portion of your estate
- Anyone who has a claim against any part of your estate
- Anyone who has direct financial responsibility for your medical care
- Anyone who is an employee of the hospital or healthcare facility at which you are a patient
If you would like more information regarding Advance Directives, please contact the Case Management Department at 302-629-6611, extension 4508.
A Living Will allows you to make decisions about life-sustaining procedures if, in the future, your death from a terminal condition is imminent despite life-sustaining procedures. A Living Will will not allow you to make decisions about future life-sustaining procedures in the event you have an end-stage condition or you are in a persistent vegetative state.
To honor your wishes as set forth in your Advance Directive For Healthcare or Living Will, a copy of the document must be placed in your medical record. We encourage all patients to take an active role in directing the course of your medical treatment decisions. Before deciding which choices are best for you, you should discuss the situation with your family and your physician.
Frequently Asked Questions
What are Advance Directives?
Formal advance directives are documents that state your choices for healthcare, or name someone to make those decisions about your medical treatment if you are unable to make those decisions yourself. Through these documents, you make legally valid decisions about future medical treatment.
It is important to remember that these directives take effect only when you can no longer make your healthcare decisions. As long as you are able to give “informed consent” your healthcare provider will rely on you and not your advance directive.
What is a Living Will?
A Living Will (or Instructions for Health Care) is a document in which you can state the kind of life-prolonging medical care you want if you become terminally ill or lapse into a permanent unconscious state.
Your Living Will goes into effect when your doctor/healthcare provider has a copy of it, they have determined that you are no longer able to make your own health care decisions, and it is determined that you are terminally ill or in a permanent unconscious state.
What is a Power of Attorney for Health Care (PAHC)?
A Power of Attorney for Health Care is another kind of advance directive—a signed, dated and witnessed document naming another person to make medical decisions for you if you are unable to make them yourself. The person you appoint should be knowledgeable of your wishes. The person should be someone you can trust and have confidence that they understand and agree to accept the responsibility. The PAHC becomes effective only when you are temporarily or permanently unable to make your own healthcare decisions and your agent consents to start making those decisions.
How can I know in advance which procedures I would want or not want?
Although it isn’t possible to specify every possible procedure under every possible circumstance, it is possible to decide what kind of treatment you want in most situations. Your doctor must inform you about your medical condition, which different treatments are available and what each treatment can do for you. Thinking about and discussing it with your family, your friends and your physician can help you clarify your preferences.
It is never too early to start this decision-making process. You should not postpone it until you face serious illness.
What if I draw up an Advance Directive and then change my mind?
You may change or revoke these documents at any time. To cancel your Advance Directive, simply destroy the original document and tell your family, friends, doctor or anyone else who has copies that you have revoked it. To change your Advance Directive, simply write a new one. It must be dated and witnessed. Make sure you give copies of the new document to your family, friends and doctor and destroy all copies of the old one.