ACKNOWLEDGMENTS

American Association of Retired Persons (AARP)
Mental Health Association in West Virginia
West Virginia Advocates
West Virginia Department of Health and Human Resources
West Virginia Health Care Association
West Virginia Hospital Association
West Virginia State Bar
West Virginia State Medical Association

As an adult, you have the right to make your own health care decisions. You may expect your doctor and other health care providers to tell you about the nature of any proposed procedure or treatment, its probable benefits or effects and any predictable discomfort, complications or risks. You have the right to know alternative treatments and their risks and benefits. You have the right to ask questions, and then you have the right to decide whether you want the treatment or not. Your right to accept medical or surgical treatment also includes the right to refuse it.

But what if, because of injury or illness, you become incapable of making health care decisions for yourself? For example, imagine you are in a hospital, terminally ill with cancer and are confused. Who should decide whether you have cardiopulmonary resuscitation if your heart should stop suddenly.? Or what if you are 40 years old and are involved in a motor vehicle accident which leaves you permanently unconscious. Who will decide whether you are to be kept alive with tube feedings? Or what if you have Alzheimer's Disease, are in a nursing home, and you develop a serious infection. Who will decide whether or not you will be hospitalized and treated with antibiotics?

Even if you cannot decide for yourself, you can remain in charge of your health care by creating a document called an "advance directive."

West Virginia law recognizes two types of written advance directives for health care decisionmaking: the Living Will and the Medical Power of attorney. The following pages present information about these directives and include the necessary forms.

You can use these documents to let your family and doctor know your decisions for health care if you become unable to decide for yourself. You can appoint someone you know and trust as your health care representative to ensure that your choice or decision is honored.

1. What is a Living Will?

A Living Will is a document that directs your doctor to withhold or withdraw life-prolonging interventions (such as cardiopulmonary resuscitation, kidney dialysis or machines to help you breathe) if you are terminally ill or in a persistent vegetative state (permanently unconscious). It tells your doctor to provide only those treatments that will relieve pain and provide comfort. You may add other special directives or limitations in your Living Will.

A Medical Power of attomey is another type of advance directive which allows you to name a person to make health care decisions for you if you are unable to make them for yourself.

A copy of the Medical Power of Attorney form is included at the end of this booklet. You may create a Medical Power of Attorney by filling out this form and having it properly witnessed and notarized.

The Medical Power of attomey allows you to appoint someone to make health care decisions for you if you cannot make them. It covers all health care situations in which you are incapable of making decisions for yourself It also allows you to give specific instructions to your representative about the type of care you would want to receive.

The Medical Power of Attorney allows your representative to respond to medical situations that you might not have anticipated and to make decisions for you with knowledge of your values and wishes.

Since the Medical Power of Attorney is more flexible, it is the advance directive most people choose. Some people, however, do not have someone whom they trust or who knows their values and preferences. These people should consider creating a Living Will.

If you choose to sign both documents, you should see that they are stored in the same place to help assure that your representative will know to respect all of your wishes.

Your representative may be someone who will inherit from your estate. You may, but do not have to, choose a family member to be your representative. Regardless of your choice, your representative should be someone who is likely to be available if needed and who will decide matters the way you would decide.

Name only one person each as your representative and your successor representative. Do not choose as your representative or successor representative your doctor or another person who is likely to be your future health care provider.

8. What instructions should I give my representative concerning my health care?

Many people choose to write their representative a letter stating their personal values and wishes, their feelings about life and death, and any specific instructions, and to attach a copy of this letter to their Medical Power of Attorney.

9. Can any person create an Advance Directive?

Make sure your representative knows where the original is so it can be shown to your doctor on request. However, a photocopy of your Advance Directive is legally valid.

If you have appointed someone as your representative under a Medical Power of Attorney, that person's consents and refusals on your behalf are as meaningful and valid as your own. The wishes of other family members do not override your own clearly expressed choices or those made by your representative on your behalf.

15. Do I have to sign an Advance Directive to receive health care treatment?

No doctor or other health care provider may require creation of an Advance Directive as a condition for you to receive services.

16. Will another state honor my Advance Directive?

Laws differ somewhat from state to state, but in general, a patient's expressed wishes will be honored. No law or court has invalidated the concept of Advance Directives, and an increasing number of statutes and court decisions support it.

17. What if I change my mind about who I want to be my representative or about the kind of treatment I want?

You should review your Advance Directive periodically to make sure it still reflects your wishes. The best way to change your Advance Directive is to create a new one. The new Advance Directive will automatically revoke the old version. Be sure to notify all people who have copies of your Advance Directive that you completed a new one. Collect and destroy all copies of the old version.

18. How can I be sure that the wishes expressed in my Advance Directive will be followed?

Be sure your doctor has a current copy. Bring a copy with you if you are admitted to a health care facility. Tell people where you keep your Advance Directive.

Cut out and complete the wallet cards on the inside back cover of this booklet, indicating where your Advance Directive can be found. Put one card in the purse or wallet you carry with you most often. Keep the second card on your refrigerator, in your motor vehicle glove compartment, a spare purse or wallet, or other easy-to-find place.

19. How can I get more copies of the Advance Directives forms and this booklet?

You may call the Office of Geriatrics and Long-Term Care, West Virginia Department of Health and Human Resources, at (304) 348-2363 between 9:00 a.m. and 4:30 p.m. weekdays, or you may write: Office of Geriatrics and Long-Term Care, Department of Health and Human Resources, Building 6, Room 850, State Capitol Complex, Charleston, West Virginia 25305.