How to keep control over your healthcare decisions
You have a fundamental right to make decisions regarding your own medical treatment, including the right to accept or refuse medical care. At this point in your life it is more important than ever that you feel in control of those decisions. It is the policy of Hospice at Home to encourage you and your family or caregivers to participate in decisions regarding your care and treatment.
Your hospice care team will follow any valid advance directives to the extent permitted and required by law such as a living will, medical power of attorney or DNR (Do Not Resuscitate) order. If you do not have an advance directive, your hospice team will provide appropriate care according to the plan of care authorized by your attending physician. Your hospice team will not alter your care or otherwise discriminate against you based on whether or not you have executed an advanced directive or DNR.
At this time it probably seems as if you have more questions than answers about how to handle and keep control of your healthcare. Here are answers to some questions you or your family may have:
Who makes your healthcare decisions?
As long as you are able, you make the decisions about your healthcare. Your doctors should tell you about the treatments they recommend, other reasonable alternatives and important medical risks and benefits of the treatments. You have the right to decide which healthcare, if any, you will accept or refuse.
What happens if you become unable to make or communicate your healthcare decisions?
The Medical Director got everything started and if it wasn't for hospice I couldn't have made it, as I felt very overwhelmed when I learned that my mother had cancer and three months or less to live.
If you plan ahead, you can still have some control over your healthcare decisions. One way to plan ahead is by making an advance directive for your healthcare. This will give you an opportunity to name someone to make healthcare decisions for you as well as your decisions of what will guide or control decisions about your care. If you have not named someone in a healthcare directive, your doctors must seek a person authorized by law to make these decisions. A person who makes healthcare decisions for you is called a surrogate.
What is a healthcare directive?
A healthcare directive is a written statement about how you want your healthcare decisions made. Under Michigan law, there are three common types of healthcare directives:
- Healthcare Power of Attorney. This is a written statement in which you name an adult to make healthcare decisions for you. That person will make healthcare decisions for you only when you cannot make or communicate such decisions, based upon your stated wishes.
- Living Will. This is a written statement about healthcare you do or do not want. It is to be followed if you cannot make or communicate your own healthcare decisions.
- DNR. The Do Not Resuscitate (DNR) order is a directive refusing certain lifesaving emergency care given either outside or inside a hospital.
Must your healthcare directives be followed?
Yes. Healthcare providers and surrogates must follow valid healthcare directives.
Can you be required to make a healthcare directive?
No. It is entirely up to you whether you make a healthcare directive. A healthcare provider may not refuse care based on whether or not you have a healthcare directive.
Can you revoke or change a healthcare directive?
Yes. You may change or revoke your healthcare directive at any time. You should notify everyone who has a copy.
Who can legally make healthcare decisions for you if you are unable to make decisions and if you have not named a healthcare power of attorney?
A court may appoint a guardian to make healthcare decisions for you. Otherwise, your healthcare provider must go down the following list, in this order, to find a legal surrogate to make healthcare decisions for you:
- Your husband or wife (unless you are legally separated)
- Your adult child (If you have more than one child, a majority decision will be made by those who are available.)
- Your mother or father
- Your domestic partner (unless someone else has financial responsibility for you)
- Your brother or sister
- Your close friend (someone who shows concern for you and is familiar with your healthcare views)
If your healthcare provider cannot find an available and willing surrogate to make your healthcare decisions for you, then your doctor can decide with the advice of an ethics committee or, if this is not possible, with the advice of another physician.
You can keep anyone from becoming your surrogate by saying, preferably in writing, that you do not want that person to make healthcare decisions for you.
A legal surrogate will not have the right to refuse the use of tubes to give you food or fluids unless:
- You have appointed that surrogate to make healthcare decisions in a healthcare power of attorney, or
- A court has appointed that surrogate as your guardian to make healthcare decisions for you, or
- You have stated in a healthcare directive that you do not want that specific treatment.
For a template of a standard healthcare directive, click here.