Newspapers / The Brunswick beacon. / Dec. 19, 1991, edition 1 / Page 10
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Changes In Laws Give Patients More Control Over Decisions alicnis have greater control over health care decisions affecting them now, as a result of changes in stale and federal law. Starting this month, a patient ad mitted to a hospital lor treatment has the opportunity to choose the type of treatment he or she will receive, even when thai person is not compe tent enough to do so lor themselves. This right is provided by the Patient Self-Determination Act ol WW. which went into ellect Dec. I. It requires all health care facilities that receive Medicare or Medicaid lunds to inform patients of their rights regarding health care deci sions. litis past summer the N.C. Cene ral Assembly passed two related slate laws. II.H x*2 expanded ihe scope of ihe slate's Natural Death Act and recognized by law a health care power of attorney. Both changes became effective Oct. I Ihe Brunswick Hospital beuan implementing the federal poiicy Dec. I. as mandated by law said Daphne Yarbrough. director of iar kcting. Other area hospitals are also implementing it. Patients are asked about advance directive documents as they are ad mitted to the hospital. Patients designate their treatment options through documents ?called advance directives? ihai must be e.xecuied before they enter the hos pital in order to apply during that hospital slay. Ms. Yarbrough said there are three types ol advance directive doc uments: a living will, a medical di rective. and designation of agent for health care decisions document. Each addresses a different area of concern. In an advance directive the indi vidual either suites choices regard ing medical treatment or appoints a health care surrogate with a durable power of attorney in the event he or she should lose the capability to make decisions. A durable power of attorney re mains or becomes effective after one becomes incapacitated. In order for the power of attorney to be durable, it must be filed at an appropriate Register of Deeds office. The Living Will A living w ill is a declaration of a desire to die a natural deaih. Through the cxecuuon of a living will, an individual states whether or not he or she would desire for life to be prolonged by extraordinary means in the event of a terminal anil incurable condition or a persistent vegetative state. The living will can instruct the doctor lo wiihold or slop extraordi nary means only, or to also w ithhold or stop artificial nutrition or hydra tion. J In order lor such a will to be le Patients designate treatment options through documents that must be executed in advance in order to apply during that hospital stay. ? Daphne Yarbrough The Brunswick Hospital gal. it must be signed by two wit nesses who arc no! related b> blixvl or marriage to ihe individual or his or her spouse, and who are not usso ciatcd with health care agencies and wIhj do not have ;i claim on the indi vidual's estate. It must also Iv signed and scaled h> .1 notary pub lic. In addition. the will can only he w ritten ami signed w hen the indmd ual is mentally alert and competent Also, a living will executed 111 North Carolina may not be valid 111 other states because the documents vary from state to state. Someone who spends a lot of time m other suites may want to sign a living w ill for each state. The Medical Directive Another type of advance directive document is the medical directive. With this, a patient is able to choose in advance the types of medical in tervention he or she may not desire in certain situations. Choices included in this docu ment can range iami the use of an tibiotics for the treatment of pneu monia to the use of cardiopulmonary resuscitation (CPR) for the purpose of bringing an individual back to life when his or her heart slops while in an incapacitating state. The patient may also use this doc uirtcnt to specify, in advance, it movement from the home, hospice or a nursing home to the hospital would be desired. The medical directive can also be used as a means of refusing treat ment. Designation Of Agent The third type of advancc direc tive is the designation of agent for health care decision, or a durable power of attorney lor health care. This document enables the individu al to name a surrogate who will make health care decisions for that individual when he or she is inca pacitated. The agent can bo anyone: friend . lamily member, attorney, whomever the individual chooses. Although North Carolina allows a person to name a surrogate, it does not specify whether the surrogate can make decisions pertaining to the w ithholding of medical treatment. I he procedures designated in an advance directive apply whenever an adult patient is admitted on an in William Temple Allen, CPA Income Tax Preparation/ Representation (federal and ail state returns) Electronic Filing and Rapid Refund Accounting and Bookkeeping Services Computerized Payroll Secretarial/Word Processing Services Medical Practice Management Services (review of ICD-9/CPT coding) Tax and Estate Planning Former IRS Assistant Director Technical Division. Washington. 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IikIivuIu.iI> with advance tliroc - lives should provide copies ol the dtvumenis lor their physicians, s|H?uscs and surrogates, or any other people who should have access to them, advises Ms. Yarbrough. Individuals should also diseiiss their wishes with then doctors and health care agents. II an admitting physician has a copy ol i he patient's advance tliivc Uve, Ik* should provide the hospital with all til the necessary information prior to the patient's admission. When the patient is admitted, he or she will be asked il a living will has Iven executed and a health care surrogate appointed, ami whether any advance directives in the patient's charts are up to dale. Once the documents are added to the patient's charts, they become a ivrmancnt part ol the patient's records. That means they will not have to be resubmitted to die hospi tal should the patient he readmitted at a later date. However, advance directives may tv revoked by the patient at any lime by destroying any original copies and notifying the family physician. They arc not considered canceled until the doctor is notified. In the event the patient is trans ferred, a copy of the advance direc lives will be sent ak>ng with other appiopriatc documents to the next facility. According to federal law, saul Ms. Yarbrough. once a patient has been hospitalized, the hospital can not obtain a living will for them or even witness the execution ol any advance directive document. Any documents must he signed and nota rized before hospitalization. Ms. Yarbrough cautions dial ail vance directives may not guarantee that a patient's wishes will Ik hon ored. The ultimate decision will be the responsibility of the attending physician, she said. His or her deci sion will he based on the patient's wishes, his ow n knowledge and the expected outcome for the patient. Still, she said, there arc many benefits for securing the documents. They expedite decision making dur ing a difficult time. All parties in volved in a patient's care know that patient's views before an urgent situ ation arises. "()l great importance also is the fuel thai it will help to avoid unnec essary pain aiul suffering lor both the patient and the family." she said. (>??{ More Information More information on advance di rectives is available from Sherry Hendricksen, R.N., director ol social services, at The Brunswick Hospital. Also, the N.C. Cooperative Extension Service has updated sev eral related bulletins to reflect changes in the laws, For more inlor mation about living wills, see The Living Will. HE 3M. for more inlor mation about health care powers ol attorney, read Health ( 'ore rawer <>/ Attorney. HE- 387, or il not avail able, the more general LckoI Authority , HE-3f>3. They can be ob tained through the Brunswick County Extension Office at Bolivia None ol the documents are a substi lute lor advice from a family attor ney . ^tee 0^ M DISCOUNT FURNITURE WAREHOUSE OF BRUNSWICK COUNTY, INC. ON L-ONG BEACH ROAD IN SOUTH PORT In-Stock Merchandise Inventory Reduction Early American 3-pc. Sofa Group Choose from blue or beige set Brown Sectional with 2 Incliners Pub Back" 3-pc. Sofa Sets 2 to choose from! Casual Crates" Table With 6 Chairs Make The Drive For Sectionals-^with sleeper & recliner Choose blue or multi-colored set .. S1 ,299s* 3-Pc. Sofa Group with wood trim *799" Queen Sleeper? povvdef blue *1h inriefspnng*499" Whitewash Table & 4 Chairs ,39995 Jumbo Bean Bags M995 "Timbertown" Solid Pine Group Double dresser w/mirror, nightstand and 2 twin headboards *399" Solid Oak Double Dresser with mirror & nightstand *399* "Casual Crates" Bar *99?? 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Dec. 19, 1991, edition 1
10
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