Advance Directives - Your Right to Direct Your Health Care

 
Door County Medical Center respects the rights of our patients to make decisions about their health care. This includes the right to accept or refuse medical or surgical treatment and the right to direct future health care decisions if the patient becomes unable to do so.  This can be done through a patient created Advance Directive. 
 
“Advance Directives” is a collective term for documents that inform healthcare providers about types of care and treatment that a patient wishes to have or not have.  An Advance Directive speaks for the patient when he or she is unable to do so and directs the patient’s wishes regarding healthcare decisions. An Advance Directive document communicates to others the care and treatments the patient does or does not want and/or who will make healthcare decisions for him or her when they cannot express their wishes.  Advance Directives can relieve the patient’s family members and friends from the burden of guessing what the patient would want to have done.  Advance Directive documents may include:
  • Declaration to Physicians - Living Will: A written document voluntarily executed by an individual that expresses his/her wishes regarding preferences of wishes about life-sustaining measures when diagnosed with a terminal condition or in a persistent vegetative state. The life-sustaining measures mentioned in the living will include treatments or machines that keep your heart, lungs, or kidneys functioning when they are unable to do so on their own.  A living will goes into effect only when two physicians, one of whom is the patient’s attending physician, agree in writing that the patient is either near death or in a persistent vegetative state that cannot be reversed and the patient is  unable to understand or express health care choices.
  • Pre-Hospital Do Not Resuscitate (DNR) Order: Signified by the patient’s “Do Not Resuscitate” bracelet that directs emergency medical technicians, first responders and Emergency Departments staff not to attempt cardiopulmonary resuscitation on a person for whom the order is issued if that person suffers cardiac or respiratory arrest. The "Do-Not-Resuscitate bracelet" is a standardized identification bracelet that bears the inscription "Do Not Resuscitate" and signifies that the wearer is a qualified patient who has obtained a do-not-resuscitate order from their attending physician and that the order has not been revoked (Wisconsin §154.17).  The written order considered a “pre-hospital DNR” for emergency medical technicians, first responders, and Emergency Department staff.  The purpose of a do-not-resuscitate order is to ensure that medical care provided in the emergency department and out-of-hospital settings, including clinic and other outpatient settings, is consistent with the patient's desire and the patient’s attending physician’s authorization.  Note:  The patient can revoke the DNR by expressing to emergency health personnel the desire to be resuscitated or by defacing, cutting, removing or asking someone to remove the bracelet.
  • Do Not Resuscitate Order: A written order completed by the patient’s provider and maintained in the patient’s health record which directs hospital/healthcare personnel not to attempt cardiopulmonary resuscitation on the patient if they suffer cardiac or respiratory arrest.
  • Power of Attorney for Healthcare (POA-HC): Means the designation in writing, by an individual, of another as his or her health care agent for the purpose of making health care decisions on his or her behalf if the individual cannot, due to incapacity.  The POA-HC also allows the individual to express their wishes on a number of health care issues.  The POA-HC will supersede conflicting provisions in a Living Will.
  • Power of Attorney for Finance and Property (POA): A "Power of Attorney" is a document whereby one person (called the "principal") authorizes another individual or entity (called an "agent" or "attorney-in-fact") to act on behalf of the principal. The most common uses for a POA are financial and property transactions. While the POA does not permit healthcare decision making, it may include provisions for payment of healthcare or access to health information.
The Wisconsin Department of Health Services has advanced directive forms available online. These forms are designed to be completed without the assistance of an attorney. The forms available are:
  • Declaration to Physicians (Wisconsin Living Will)
  • Power of Attorney for Health Care
  • Power of Attorney for Finance and Property 
  • Authorization for Final Disposition
The forms can be found at:  https://www.dhs.wisconsin.gov/forms/advdirectives/index.htm
 
Door County Medical Center has also created a “Power of Attorney for Healthcare” packet which can be printed and completed.  Click HERE to access and print out.
 
Completed Advance Directive documents should be forwarded to Door County Medical Center to be included in the patient’s health record.
Notice of Nondiscrimination:  English

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