00:01
When you're talking about
the actual forms,
there are two kinds of
advanced directive documents.
00:06
There's a living will,
and there's a durable power
of attorney for healthcare,
otherwise known as I said,
as a health care proxy
or health care agent.
00:16
So, a Living Will are
the actual instructions
that might be put in the document
about particular medical decisions,
especially if a particular
condition occurs,
like the person has
a terminal illness.
00:27
It does often comment on whether the
patient would want comfort measures.
00:32
So if they are near
the end of life,
would they want comfort measures
even if it might hasten their death?
But it helps to relieve
any kind of pain or discomfort
that they might be having.
00:44
The difficulty with living wills
is often they're just
too general in language.
00:48
And they will still
require interpretation
based on a particular
clinical context for the patient.
00:55
So for instance, there might be
an advanced directive that says,
"Well, if I'm in a permanent coma,
I would never want artificial
nutrition and hydration."
But what if the
person has a stroke,
and is now in a minimally
conscious state?
They're not all the
way being comatose,
but they're minimally conscious.
01:12
Maybe the Advanced
Directive document
doesn't speak to that condition.
01:16
There's going to need
to be interpretation
by their healthcare proxy,
in partnership with
the health care team
about how to handle those questions
about life sustaining treatment.
01:29
I think the most important document
better than the living will
is going to be the durable power
of attorney for health care.
01:36
So this is going to
take effect anytime
the patient loses
decision making capacity.
01:40
It's not just when they have
a terminal illness,
but anytime they lose capacity,
this person can step in and
make decisions on their behalf.
01:49
It's important to note that
it's not the same thing
as a power of attorney
for financial decisions.
01:54
So, some patients will
designate a person
to take care of
their financial affairs.
01:59
If it's a document
just for the finances,
that does not mean that
they can make decisions
for healthcare decisions.
02:06
They have to make sure when they
complete an advanced directive
that's a durable power of
attorney for health care
that it is for health care.
02:14
That it is for these
medical decisions.
02:18
And often,
it gives the proxy broad authority
to make any kind of
healthcare decisions.
02:25
There may be limitations
based on particular jurisdictions.
02:28
But in general, it allows the proxy
to consent to medical procedures
and the medical treatments
to decide on who that patient's
health care providers should be.
02:38
It could figure out,
who is going to treat the patient?
But also where they're
going to be treated?
Is it going to be in a hospital?
Is it going to be a nursing home?
Is it going to be at home?
It's going to be an
ability for this proxy
to receive the patient's
medical information.
02:53
Any health information
that's going to be relevant
to them making decisions
that can get access to it.
02:58
So it's an aspect of thinking about
respect for privacy of the patient.
03:03
this person is designated
to receive this information
to then serve as the
authorized decision maker.