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Making Decisions About Care

Patient Advance Directives: End-of-Life Decision Making

When an unexpected accident or serious illness makes it impossible for you to make health care choices, others will make those decisions for you.  Developing an advanced directive is the only way to be certain that your loved ones and caregivers understand your end-of-life wishes, and that they respect your intentions.

    • patient advance directives | end of life decision makingPatient advance directives are documents that contain guidelines for end-of-life care and decision-making.  An advance directive allows you to specify the conditions for a wide range of future health care decisions, and allows you to appoint a health care agent to act on your behalf. 

      A health care agent can be your spouse, an adult child, other family member or a friend.  The only exception is that a health care agent may not be your treatment facility’s employee, owner or operator. 

      You can also choose when your agent can decide for you. For example, your agent may be given authority to make medical decisions only after two doctors agree that you are not able to do so yourself. You can also give your agent very broad or very specific powers in deciding about life-sustaining treatment.

      If you don’t select a health care agent, Maryland law allows a surrogate to make medical decisions for you. The state would ask your closest relative, or if a relative is not available, the state can appoint a close friend as surrogate.  But a surrogate might have less authority to decide against life-sustaining procedures than a health care agent.  If there is no one to be a surrogate, a court might have to appoint a guardian to make your medical decisions. The guardian might be someone who does not know you personally. 

    • You can also make an oral Maryland advance directive to your doctor with a witness. You can use oral patient advance directives to name a health care agent, to make decisions about life-sustaining procedures, or both.

    • A patient living will is one type of advance directive. When you make a living will it should include those life-sustaining procedures that you would want to be provided, withheld, or withdrawn if you become terminally ill, are in a persistent vegetative state, or have an end-stage condition. An end-stage condition is an advanced, progressive and incurable condition resulting in complete physical dependency. 

Learn How to Make a Living Will and More about Advance Directives

We encourage you to make an advance directive, and we’ve provided the State of Maryland advanced directives form and the Holy Cross Hospital Living Will form to help you get started:

If you are a patient and would like more information, please ask your nurse.

Consulting the Ethics Advisory Committee

Occasionally, patients, families and other members of the community will wish to consult with the Holy Cross Health Ethics Advisory Committee about specific difficult issues that arise during the course of medical treatment or care received.   All Holy Cross Health patients have the right to seek counsel from the Ethics Advisory Committee about difficult ethical cases.

The Holy Cross Health Ethics Advisory Committee is comprised of an interdisciplinary team of health care professionals and specially trained individuals to assist patients, families and health care providers in clarifying ethically sensitive issues.

To consult the Ethics Advisory Committee, please call 301-754-7024.

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