Temecula Elder Law attorneys explain the differences between an Advanced Health Care Directive and a Do Not Resuscitate order.
Just as we create estate plans for our eventual demise, we also need to plan for the possibility that we will become sick and unable to make our own medical decisions. Medical science has created many miracles, among them the technology to keep patients alive longer, sometimes indefinitely. As a result of many well-publicized “right to die” cases, states have made it possible for individuals to give detailed instructions regarding the kind of care they would like to receive should they become terminally ill or are in a permanently unconscious state. These instructions fall under the general category of “end-of-life care decision making.” In California, this document takes the form of an Advance Health Care Directive.
California also has a Do Not Resuscitate order and families have expressed concerns as to what are the differences between these two documents. Read on as our Temecula Elder Law experts explain each document and their purposes.
Advance Health Care Directive
Such directives provide the agent with instructions on what type of care the principal would like. It may contain directions to refuse or remove life support in the event the principal is in a coma or a vegetative state, or it may provide instructions to use all efforts to keep the principal alive, no matter what the circumstances. Medical directives can also be broader statements granting general authority for all medical decisions that are important to the principal. These broader medical directives give the agent guidance in less serious situations.
With the strict new health care, privacy rules now in force, it is more crucial than ever that everyone consider creating an advance medical directive that specifically names those persons who are entitled to access to health care information about them. Under the privacy rules of the Health Insurance Portability and Accountability Act (HIPAA), which became effective in April 2003, doctors, hospitals, and other health care providers may no longer freely discuss a patient’s status or health with spouses or other family members — unless the providers have in hand-signed consent forms from the patient. Remember: a general power of attorney for financial matters will not suffice. The instrument must refer specifically to HIPAA.
It is a particularly good idea to create Advance Health Care Directives (AHCD) with a Temecula Elder lawyer to plan for the possibility that you may one day be unable to make your own medical decisions.
Do Not Resuscitate (DNR)
The Prehospital Do Not Resuscitate (DNR) Form is an official State document developed by the California EMS Authority, in concert with the California Medical Association and emergency medical services (EMS) providers, to instruct EMS personnel regarding a patient’s decision to forgo resuscitative measures in the event of cardiopulmonary arrest. Resuscitative measures to be withheld include chest compressions (CPR), assisted ventilation (breathing), endotracheal intubation, defibrillation, and cardiotonic drugs (drugs that stimulate the heart).
The form does not affect the provision of life-sustaining measures such as artificial nutrition or hydration or the provisions of another emergency medical care, including treatment for pain, difficulty breathing, major bleeding, or other medical conditions.
The DNR must be signed by the patient or by the patient’s legally recognized healthcare decisionmaker if the patient is unable to make or communicate informed health care decisions. The patient’s physician must also sign the form, affirming that the patient/legally recognized health care decisionmaker has given informed consent to the DNR instruction.
What Is the Difference Between an Advance Health Care Directive and a Do-Not-Resuscitate Order
There can be confusion about the difference between an AHCD and a “do-not-resuscitate” order (DNR). While both these documents are advance medical directives, they serve different purposes.
The DNR form should be posted or maintained near the patient. A DNR is a separate document, not part of the AHCD.
Making end-of-life decisions is an exceedingly difficult and emotional process, and sometimes there is confusion on what legal documents you should have, if you are interested in learning more about which documents you may need, speak to our Temecula elder law or estate planning attorneys. To schedule an appointment at our Temecula office or one of our other offices located throughout the state of California, contact us at (800) 244-8814