Legal decisions for people admitted to a hospital may involve
What happens when people become unable to make health care decisions themselves (advance directives Advance Directives Health care advance directives are legal documents that communicate a person’s wishes about health care decisions in the event the person becomes incapable of making health care decisions. There... read more , including living wills Living Will Health care advance directives are legal documents that communicate a person’s wishes about health care decisions in the event the person becomes incapable of making health care decisions. There... read more and durable power of attorney for health care Health Care Power of Attorney Health care advance directives are legal documents that communicate a person’s wishes about health care decisions in the event the person becomes incapable of making health care decisions. There... read more )
Whether or not people agree to have an invasive procedure to help diagnose or treat a disorder (informed consent Informed Consent Before performing any invasive test or providing medical treatment, doctors must obtain permission from a competent patient in a manner that is informed and voluntary. The process is known as... read more )
Living wills
A living will Living Will Health care advance directives are legal documents that communicate a person’s wishes about health care decisions in the event the person becomes incapable of making health care decisions. There... read more expresses, in advance and in writing, a person's instructions or preferences about future medical treatments, particularly at the end of life, in case the person becomes unable to make health care decisions. It spells out what care the person would want under different circumstances. It can and should include preferences for resuscitation Preferences for resuscitation Hospitals provide extensive resources and expertise that enable doctors to rapidly diagnose and treat a wide range of diseases. However, a hospital can be a frightening and confusing place.... read more .
Durable power of attorney for health care
An illness may prevent people from communicating or understanding what is happening to them. Thus, all people over 18 years old should designate a person to make medical decisions on their behalf (sometimes called a health care agent) in a document called a durable power of attorney for health care Health Care Power of Attorney Health care advance directives are legal documents that communicate a person’s wishes about health care decisions in the event the person becomes incapable of making health care decisions. There... read more . This document is necessary in addition to a living will because a living will cannot cover all possible situations. Thus, in some situations, someone is needed to use judgment to determine the care the incapacitated person would want.
The legal authority to make medical decisions on a person's behalf is different from a durable power attorney for financial decisions, which allows someone to make financial transactions on a person's behalf.
The agent with durable power of attorney for health care can make medical decisions on behalf of a person only when the person is unable to communicate—for example, because the person is unconscious or has a medical condition that causes confusion. The agent should be someone the person trusts and is usually a family member or close friend. Giving only one person this authority is helpful. If it is given to several people, they may disagree with each another about medical decisions.
A person can revoke the durable power of attorney for health care or designate a different health care agent at any time.
The agent is legally bound to follow the person's treatment preferences to the extent that the agent knows about them. Therefore, people should tell their agent what they would like done in certain circumstances.
Laws differ from state to state as to how the document is prepared. The web site for each state's medical association has additional resources about how to prepare a durable power of attorney for health care and what issues people should consider. Other helpful resources include the primary care practitioner, the family lawyer, or a hospital social worker.
If a person has not designated a durable power of attorney for health care and is unable to communicate, doctors ask the person's next of kin to help make decisions on the person's behalf (see Default Surrogate Decision Making Default Surrogate Decision Making If a person is unable to make decisions about personal health care, some other person or people must provide direction in decision making. The general term for such person is surrogate decision... read more ).
Informed consent
Before doing an invasive diagnostic test or providing certain medical treatments, doctors must obtain informed consent Informed Consent Before performing any invasive test or providing medical treatment, doctors must obtain permission from a competent patient in a manner that is informed and voluntary. The process is known as... read more from the person who is having the test or treatment (or the agent named in the durable power of attorney for health care document). For consent to be informed, doctors must discuss the following in a way the person can understand:
What the test or treatment involves and why it is being recommended
What the benefits and risks of the test or treatment are
What alternatives are available and what their risks and benefits are
What the risks and benefits of not having the test or treatment are
If the person agrees to proceed with the test or treatment, doctors ask the person to sign a form indicating that the person received the appropriate information.
Doctors do not formally talk with people about inserting routine intravenous (IV) lines, taking x-rays or CT scans, or prescribing routine drugs (such as antibiotics) beforehand. However, people can ask their doctors about the common side effects of any test or drug.
