Legal & Ethical Decisions (Advance Directives)
Rochelle Community Hospital would like you to know about the Illinois laws involving the rights of hospitalized patients to make decisions regarding medical care. On this page, various options for advance directives such as powers of attorney, living wills, do-not-resuscitate (DNR) orders and surrogate decision makers will be discussed.
Competent adults have the right to make decisions regarding their healthcare. The courts of this state have recognized that this right should not be lost when a person becomes unable to make his or her own decisions. Therefore, people have the right to accept or refuse any medical treatment, including life-sustaining treatment. In order to enable them to make these decisions, patients have the right to be adequately informed about their medical condition, treatment alternatives, likely risks and benefits of each alternative and possible consequences.
The law now requires that patients be informed of the advance directives available to help assure that their wishes are carried out even if they are no longer capable of making or communicating their decisions. This document describes the advance directives that are recognized in Illinois. It should be kept in mind that every patient has the right to choose whether or not he or she wants to execute an advance directive. You are encouraged to discuss the subject of advance directives with your physician.
Upon being admitted to the hospital, you will be asked if you have advance directives. If you do not have them, you will be given an opportunity to execute such directives. If you do have advance directives, please provide a copy for your hospital medical record.
One such directive is called the Power of Attorney for healthcare. A POA is a document that permits a patient to delegate to another person, the power to make healthcare decisions the patient currently is unable to make.
The scope of the power given to be the POA may be as broad or narrow as the patient wishes. The standard form grants broad medical decision-making power that the patient may limit. The law does not, however, require that this particular form be used.
The person designated by the POA can be anyone other than the patient's physician or healthcare provider. This person will have final decision-making authority, even more than a court-appointed guardian would have. However, a court may step in when it is shown that decisions are not being made in accordance with the terms of the POA.
The person designated by the POA cannot accept payment and if this person cannot or will not serve, a successor may be appointed. The patient's physician must be informed of POA relationships by the patient and/or the person designated in the POA. The patient may alter or revoke the assigned POA at any time.
Another directive is the Living Will. The Living Will is a document that allows patients to describe their wishes about the discontinuance of the death-delaying procedures when they become terminally ill. Because a Living Will is a statutory creation, the law must be followed carefully for it to be effective. The Living Will Act provides a form, but does not require the use of that particular form.
A Living Will may be made by any person who is able to make his or her own decisions and who is at least 18 years old, but it will not go into effect until the person who makes it is in a terminal condition. A terminal condition is defined as an incurable and irreversible condition which is such that death is imminent and the application of death-delaying procedures serves only to prolong the dying process.
Once the patient has a terminal condition, the Living Will can say that no death-delaying procedures should be used. Such procedures are those that serve only to postpone the moment of death. Procedures to ease pain are not considered death-delaying procedures.
Under the Act, the patient must inform the physician of the existence of the Living Will. If the physician does not wish to comply with the provisions of the Living Will, he/she must tell the patient, who may then transfer to another physician. The patient may revoke the Living Will by destroying it or indicating orally - or in writing - that he/she wishes to revoke the Living Will. If the patient is pregnant and death-delaying procedures would allow fetal development to the point of live birth, the Living Will cannot take effect.
If a patient has both a Living Will and a person designated in the POA for healthcare, then the Living Will does not take effect unless this person is not available.
Do Not Resuscitate or no-code orders are doctors' orders that tell nursing and hospital staff that if a patient suffers cardiac arrest (heart attack) or respiratory arrest (stops breathing), the patient does not wish to be revived. Good medical practice and the policies of most facilities require that cardiopulmonary resuscitation (CPR) be started unless there is an order to the contrary in the patient's chart. DNR orders are consistent with the other advance directives discussed here, but are not substitutes for these.
These are some of the ways you can ensure that your medical treatment will be handled according to your wishes even if you are no longer able to communicate your desire. If you have not executed an advance directive, decisions regarding your healthcare will have to be made by someone else (who might not be the person you would have chosen) and may place additional burdens on your family or physician. If you suffer from a terminal condition, permanent unconsciousness or an incurable or irreversible condition and lack the ability to make decisions, a healthcare surrogate may be chosen to make life-sustaining decisions for you. The surrogate who would act in such a case would be (in order of priority): guardian of the person, spouse, any adult children, either parent, any adult brother or sister, any adult grandchildren, a close friend or guardian of the estate. Under other circumstances, legal action may be required to have decisions made on your behalf.
For more detailed information or if you desire forms used for executing Living Wills or Power of Attorney, please contact the Hospital Case Management Department at 815-562-2181, ext. 2593 or ext. 2590.