Ethics + Patient Rights Terms You Need to Understand
A terminal condition is an incurable or irreversible condition that, in your doctor's opinion, would result in death in a relatively short time without the use of life-sustaining medical procedures.
A life-sustaining procedure is any medical treatment or procedure without which a patient cannot survive. This does not include procedures that your physician may order to provide care or comfort, or reduce pain. Questions about the kinds of procedures that are often used when illness is severe, especially when recovery is unlikely, should be answered by your doctor.
Some examples of life-sustaining treatment are:
- Cardiopulmonary resuscitation (CPR): a medical procedure that may involve forceful pressure on the chest, the administration of drugs or electric shock to restore the heartbeat at the time of cardiac arrest.
- Ventilator support: a method of assisting the patient who cannot breathe naturally, using a ventilator machine to move air into the lungs.
- Artificial nutrition and hydration: a method of feeding food and water to a person who cannot eat or drink. A person may be fed through a tube inserted into the stomach directly or via the nose and throat, or through an intravenous tube.
A living will is a document that allows you to tell your doctor to withhold or withdraw life-sustaining medical procedures in case you develop a terminal condition and can't communicate your wishes. Your instructions will then be followed if you are unable to make or state your decisions at the time a medical decision must be made.
Durable power of attorney for health care
A durable power of attorney for health care (in Massachusetts, a health care proxy) is a document in which you name another person as your agent to make health care decisions for you in case you become unable to make those decisions for yourself. If you know in advance that you would prefer to have or avoid certain treatments, such as surgery or artificial nutrition or hydration, you may include such instructions in the document.
An agent has the legal authority to make the medical treatment choices you would have made yourself if you had been able to do so, including a decision to withhold or withdraw life-sustaining procedures in case you develop a terminal illness. Selection of your agent is the single most important part of preparing your durable power of attorney for health care. Most people select a family member or friend to be their agent. Speak to the person beforehand to explain your intentions, values, attitudes and general philosophy about physical or mental disability or illness during the final stages of your life. Your agent must be willing to act on your behalf and carry out your wishes. Your agent may not be someone associated with the health care provider or facility providing your care or treatment, such as your doctor or hospital personnel, unless that person is also your relative.
You may want to consider naming one or two alternate agents who could step in and make health decisions for you if, for some reason, your agent is unable to do so. However, your agent may not delegate the authority to make health care decisions to anyone else. Always include the name, address and telephone number of each person named, and state who is the primary agent, who is the first alternate and who is the second alternate.