For Patients
Making
Decisions About Your Care
In the event that an unexpected accident or illness takes
away your ability to make health care choices, others may be obligated
to make those important decisions for you. There is a way, however,
to ensure that your intentions about your care will be respected by
your medical caregivers—create an advance directive.
What is an Advance Directive?
Advance directives are typically written documents
that convey an individual’s
intentions for the provision, withholding or withdrawal of life-sustaining procedures.
An advance directive allows an individual to specify the conditions for a wide
range of future health care decisions
The State of Maryland released a new version
of the state’s advance directives
forms in May 2006.
Living Wills
A living will is one type of advance directive. The living will
is a document that allows you to state whether you want life-sustaining
procedures provided, withheld, or withdrawn if you should become
either terminally ill, 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.
Advance Directives and Health Care Agents
Generally, an advance directive is a broad document that allows
you to appoint a health care agent to act on your behalf, leave
instructions for any type of medical care, or both.
Oral Advance
Directives
Maryland law also allows you to make an oral advance directive
to your doctor with a witness. Oral advance directives can be used
to name a health care agent, to make decisions about life-sustaining
procedures, or both.
Naming a Health Care Agent
You can name anyone to be your health care
agent – your spouse,
an adult child, other family member or a friend. The only exception
is that a health care agent may not be an employee, owner or operator
of a health care facility where the patient is being treated, unless
the agent would also qualify as a surrogate.
You 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 choose the
kinds of decisions your agent can make for you. For example, you
can give your agent very broad or very specific powers in deciding
about life-sustaining treatment.
It is important to pick your health
care agent carefully. Make sure your agent knows what you want.
Your agent must then follow your wishes, even if your friends or
family disagree.
What Happens if You Do Not Make an Advance Directive
No one can deny you health care because you do not have an advance
directive. But you should know what happens legally if you do not.
Maryland
law allows a surrogate to make medical decisions for you if you
have not named a health care agent and are no longer able to
decide treatment issues yourself. Then, your closest relative
would be asked to make health care decisions for you. If a relative
is not available, a close friend can be appointed as surrogate.
However, 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.
Surrogate Decision Making
When a patient does not have a written advance
directive, we follow Maryland law regarding “surrogate” decision
making, which recognizes spouses/domestic partners, adult children,
parents, siblings, or friends or other relatives as surrogate decision
makers. Again, Holy Cross Hospital strongly encourages everyone
to have an advance directive.
If a patient has not picked a health care agent and is no longer able to make
health care decisions personally, a surrogate may do so. Surrogates are listed
in priority order. Individuals in a particular class may be consulted only if
all individuals in the next higher class are unavailable:
- A guardian, if one has been appointed by a court
- The patient’s spouse/domestic partner
- An adult child of the patient
- A parent of the patient
- An adult brother or sister of the patient
- A friend or relative who specifies in writing that he or she
is a close friend of the patient and provides facts to demonstrate
enough regular contact with the patient so as to confirm sufficient
familiarity with the patient’s activities, health and personal
beliefs
Learn More About Advance Directives
Holy Cross Hospital offers information regarding advance directives
to patients and the community through:
- On Your Behalf: an in-house video that airs on Channel 6 at
noon and 5:30 p.m. daily.
- Advance Directive Information Line: 301.754.7390
- Education Sessions: Holy Cross Hospital has staff available
to speak with church and/or community groups regarding Advance
Directives. If your organization is interested, please call 301.754.7160 to arrange for a group session.
This summary does not cover every issue. If you have legal questions
about your rights, please consult a lawyer. Also, talk to your health
care provider about the medical issues involved in your care. Tell
those caring for you about your decisions and give them a copy of
any advance directives.
Consulting the Ethical Advisory Committee
Occasionally, patients, families and other members of the community will wish
to consult with the Ethical Advisory Committee about specific difficult issues
that have arisen or could potentially arise throughout the course of medical
treatment or care received at Holy Cross. All Holy Cross patients have the
right to seek counsel from the Ethical Advisory Committee about difficult ethical
cases.
The Holy Cross Hospital Ethical 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, identifying values and weighing all the elements
and consequences of proposed personal, medical and institutional
decisions.
The Ethical Advisory Committee of Holy Cross Hospital exists to
advise on various ethical issues. Its advice reflects values and
patterns of human response consistent with the philosophy of the
Congregation of the Sisters of the Holy Cross on health care and
the values of the hospital community.
The Ethical Advisory Committee examines overall ethical issues
and provides guidelines to:
- Preserve patients’ rights
- Educate the Holy Cross Hospital community
- Provide interdisciplinary exchange and dialogue
To consult the Ethical Advisory Committee, please call 301.754.7025.
Return to top.