If you don`t have any medical problems now, your family history could be a clue to help you think about the future. Talk to your doctor about decisions that might arise if you develop similar health problems to other family members. The advance directive of the next generation was always drawn from existing law – especially commercial law. Powers of attorney laws have existed in the United States since the days of common law (i.e., laws brought from England to the United States during the colonial period). [28] These early powers allowed a person to appoint someone to act in his or her place. Based on these laws, documents for « continuing powers of attorney for health care » and « powers of attorney for health care » were created and codified by law, so that a person can appoint someone to make health care decisions on their behalf if they are unable to make their wishes known. [29] The designated health officer has essentially the same rights to request or refuse treatment that the person would have if they were still able to make and communicate health care decisions. [29] The main advantage of second-generation living wills is that the appointed representative can make decisions in real time in real-world circumstances, as opposed to preliminary decisions made in hypothetical situations such as those recorded in a living will. This New Living Testament was strongly supported by the United States. Public and supportive laws quickly followed in virtually every state. [29] Similar problems could arise if there is no legal surrogate mother specified in a continuing power of attorney for health care. A family member or friend may need to try to decide on behalf of the patient.
The spouse is generally considered the ideal surrogate, but what if the couple has marital problems? Disagreements may arise between the patient`s spouse and adult children, especially if the spouse is not the children`s parent. Adult children may disagree with each other, especially in situations where a child has lived far away for much of the patient`s last years and has only flown now to « take control. » Decisions can be made on the basis of revenge, bitterness or guilt. As in the case of an unworthy power of attorney, adult children may have a direct interest in an untimely death in order to obtain an inheritance. But even morally honorable children can cause conflicts with a patient due to religious differences. The patient and other family members may have different religious beliefs about certain types of treatments, which can affect how the family member decides for the patient when asked. In the following, the problems that can arise with living wills are highlighted: At one point, however, gaps in « second generation » living wills were quickly detected. First and foremost, people faced problems similar to those of living wills – they knew what to say to the proxy decision-maker about their wishes in a meaningful way. Studies have shown that most of what is said to appointed deputy ministers is too vague for meaningful interpretation. [30] [31] [32] [33] [34] In the absence of meaningful information, family and physician « guesswork » is inaccurate in 76% of cases. [31] [35] [36] [37] [38] [39] [40] [41] Although one study compared decisions made by the next of kin on behalf of a person with a disability (who subsequently recovered), these surrogates collectively chose correctly 68% of the time. [42] This persistent problem led to the development of what are known as « third-generation living wills. » A living will is a legal document used to record certain future health decisions only when a person is unable to make the decisions and decisions themselves.
A living will is only used at the end of life when a person is terminally ill (incurable) or permanently unconscious. The living will describes the type of medical treatment the person may or may not want to receive in these situations. It can describe under what conditions an attempt to prolong life should be started or stopped. This applies to treatments, including but not limited to dialysis, tube feeding, or maintaining vital functions (such as the use of ventilators). Planning ahead involves learning the types of decisions that may need to be made, considering those decisions ahead of time, and then informing others – your family and health care providers – of your preferences. These preferences are often included in an advance directive, a legal document that only takes effect when you are unable to work and cannot speak for yourself. This can be the result of a serious illness or injury, regardless of your age. This helps others know what kind of medical care you want. A DNR or DNR order means that if you stop breathing or your heart stops, nothing will be done to try to keep you alive.
If you are in the hospital, you can ask your doctor to add a DNR order to your medical record. You would only ask if you don`t want hospital staff to try to resuscitate you when your heart or breathing stops. Some hospitals require a new DNR order every time you are admitted, so you may need to ask for each time you go to the hospital. But remember that this DNR order is only valid while you are in the hospital. Outside of the hospital, it`s a little different. You should check your living wills regularly to make sure they still meet your wishes. If you want to change something about an advance directive after you fill it out, you should fill out a brand new document. For more information on creating an advance directive, please see: What is an advance directive? A continuing power of attorney for health care, also known as a medical power of attorney, is a legal document in which you designate someone as your substitute decision-maker to make all your health decisions if you are unable to do so. Before a medical power of attorney can be used as a guideline for medical decisions, the physician must certify to a person that the person is incapable of making their own medical decisions. You can decide how much authority your agent has over your medical care, whether they are allowed to make various decisions, or just a few specific decisions. Try not to include policies that prevent the officer from performing his or her duties. For example, it`s probably not uncommon for someone to say, « I don`t want to go to a nursing home, » but think carefully about whether you want such a restriction on behalf of your patient.
Sometimes, for financial or medical reasons, this may be the best choice for you. Other advance planning documents. You can also prepare documents to express your wishes regarding a single medical condition or something that is not already included in your advance directive. A living will usually only covers specific life-sustaining treatments that have been discussed previously. You may want to give your healthcare provider specific instructions on other topics, such as blood transfusions or kidney dialysis. This is especially important if your doctor suggests that such treatments may be necessary in the future due to your medical condition. It is difficult to predict the future with certainty. You may never be faced with a medical situation where you are unable to speak for yourself and announce your wishes. But a precautionary order can give you and your loved ones some peace of mind. Organ and tissue donation allows organs or body parts of a generally healthy deceased person to be transplanted into people who need them. Usually the heart, lungs, pancreas, kidneys, cornea, liver and skin are donated. There is no age limit for organ and tissue donation.
You can carry a donation card in your wallet. In some states, you can add this decision to your driver`s license. Some people also include organ donation in their retirement planning documents. Living wills seem like a good idea, but they are controversial. Controversial issues include whether living wills create more confusion than clarity about a patient`s wishes, whether they can still be seen as an expression of a patient`s true wishes, and whether health care workers should always follow them. The next widely accepted third-generation living will is the Medical Directive,[49][50] written by Emanuel and Emanuel of Massachusetts General Hospital and Harvard Medical School. It is a six-page document that provides six case scenarios for medical decision-making in advance. The scenarios are each associated with a list of commonly considered medical interventions and interventions, allowing individuals to decide in advance which treatments are desired or not in the circumstances. Several criticisms have been made of this advance directive. [50] [51] [52] First and foremost, it encourages individuals to make medical treatment decisions for which they are not usually equipped. [51] Several states offer « registries » of living wills where citizens can submit their living wills to make them easier and more accessible to doctors and other health care providers.