Honoring a Patient's Advance Directives
What are Advance Directives?
These are legal forms that allow adult patients to state their health care wishes. These papers let others know about your wishes and can help guide your medical care in the event you are unable to make your own decisions in the future. There are two kinds of advance directives – the Power of Attorney for Health Care and the Living Will.
The Power of Attorney for Health Care allows you to name the person(s) that you want to make health care decisions for you, in the event that you are unable to understand your health care or to express your wishes. The document can be helpful whenever you might be unable to communicate your wishes, whether short-term due to illness or injury, or at the end of life.
The Living Will (Declaration to Physicians) allows you to state your care wishes, if you have a terminal condition or you are in a vegetative state (permanent coma).
If you would like more information or wish to complete one of these forms, please ask your nurse or social worker, or contact Patient Relations at 263-8009.
Can Advance Directives be changed?
Yes. To update your Advance Directive, just complete a new form. If you want to cancel it, please talk with your social worker or Patient Relations at 263-8009.
Who makes medical decisions when a patient can no longer do so?
Patients who have a Power of Attorney for Health Care will have a health care agent. Most often, this is a family member or close friend. When doctors determine patients can no longer make their own medical decisions, the health care agents will be asked to do so.
When patients don’t have a Power of Attorney for Health Care, we ask family members to make decisions on the patient’s behalf unless a guardian has been appointed by the Court to make them.
What are UW Hospital and Clinics’ policies on end-of-life matters?
UW Hospital and Clinics honors patients’ advance directives to the extent allowable by law.
Adult patients who can make their own decisions have a right to refuse or stop any and all forms of medical treatment. This includes life-sustaining medical treatment, such as dialysis, breathing machines (ventilators), feeding tubes, and cardiopulmonary resuscitation (CPR).
At UW Hospital and Clinics, we do all we can to promote health. If your heart stops beating or you stop breathing, we will attempt CPR unless you and your doctor have decided that you do not want CPR. If you make that decision, your doctor will write a Do Not Resuscitate Order (DNR) in your medical record. If you do not want CPR, please be sure to talk with the doctor caring for you to request that an order be written each time you are hospitalized.
If you have a DNR Order and are planning to have surgery, please talk with your doctor about the status of your DNR Order. Generally, DNR Orders are not in effect while a patient is in surgery at UW Hospital and Clinics.
Patients who won’t benefit from CPR due to a medical condition may ask their doctors to write an Out of Hospital DNR Order. Patients who have this type of DNR Order wear a special wristband when they are not in the hospital. The wristband lets emergency medical service staff know of the patient’s wish not to be resuscitated in the event of a cardiac or respiratory arrest. According to state law, these orders are valid only in Wisconsin.
If a patient has a life-threatening emergency in one of our clinics, the patient will likely be transported to the UWHC Emergency Department. This action allows patients to receive or refuse life-sustaining care should they so choose and provides for patient comfort. All patients wearing an Out of Hospital DNR wristband will receive comfort measures only during transport.
The UW Hospital and Clinics Ethics Committee can help patients, families, and members of the health care team talk about ethical issues that may arise in the care of patients such as not starting or stopping life-sustaining treatment. To talk with someone from the Ethics Committee, call Patient Relations at 263-8009.
Questions?
Please talk with your social worker or call the Learning Center at 26-LEARN or the Patient Relations Department at 263-8009.
For further details, a video can be viewed at 9:00 am, 11:00 am, 1:00 pm, 3:00 pm, 5:00 pm, 7:00 pm and 9:00 pm on Channel 2. This video is brought to you by the Friends of UWHC.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 05/23/2012
Copyright © 05/23/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6162
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