Health Care Directives

The patient, under state law, has the right to make decisions concerning his/her medical care including the right to accept or refuse medical or surgical treatment and the right to formulate Advance Directives regarding these rights.

It is the policy of Mid-Valley Hospital to respect and encourage patients to control the decisions relating to the rendering of their own health care, including the decision to have life sustaining treatment withheld or withdrawn in instances of a terminal or permanent unconscious condition.

The patient's right to proper care will not be changed in any way if he/she does not have an Advance Directive.

What is a health care directive?

A health care directive allows individuals to express their desire to forego technical heroics should a terminal condition develop with no reasonable hope of recovery.

Why a health care directive?

Not only does such a document expedite a patient's wishes, it closes the matter to speculation, making the choice to maintain life sustaining treatment in a terminal condition far less difficult for family members.

Who can complete such a document?

Anyone 18 years of age or older and of sound mind may sign a health care directive. If an individual wishes, specific conditions under which a health care directive would become effective may be enumerated.

Where can a health care directive be obtained?

Many physician offices and hospitals have health care directive forms available as do many attorneys' offices. Such a document can also be requested from: Mid-Valley Hospital, 810 Jasmine St, Box 793, Omak, WA 98841.

Must the document be witnessed?

A health care directive must be signed in the presence of two witnesses. Those who cannot serve as a witness include a relation by blood or marriage; a beneficiary; the physician or hospital treating the patient; or a claimant against the declarers estate.

How is the health care directive put into effect?

The patient must have a "terminal condition" as determined by two physicians, one of whom must be the attending physician. This "terminal condition" must require the use of life-sustaining procedures which are in operation only to postpone the moment of death before a health care directive can be put in effect. The terms of a health care directive are not effective, however, if the patient is pregnant.

Can the document be revoked?

A health care directive can be revoked at any time only by the person who executed it, regardless of mental state or competency.

Where should the directive be filed?

The original document should be filed in an individual's medical records with his or her attending physician. An additional copy should also be included in hospital records as well as in the individual's personal files. People who have made a decision to sign a health care directive might also carry a card in their wallet reflecting their wishes. A card entitled, "My Thoughts on Dying" is available from the Washington State Medical Association. The card does not take the place of a living will.

Is a durable power of attorney necessary in addition to a health care directive?

Most attorneys advocate a durable power of attorney in addition to a health care directive. A durable power of attorney is a legal document that takes effect only when a person is incapacitated. It authorizes an individual to act on another persons behalf. As applied to medical treatment, a durable power of attorney designates a "decision-maker." With a health care directive, only the terms and conditions in which treatment is given or withheld are defined.

Why is it important to discuss a health care directive with family members?

Physicians sometimes find themselves in a situation where elderly patients have made it clear they do not want to receive life sustaining treatment if in a terminal condition. In many cases, however, the patients fail to inform family members of their wishes, and the patient's adult children may insist on treatment.