Advance Directives

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Today, remarkable advances in medical science are giving people new opportunities for full and productive lives. But progress brings new issues. Through medical science, we can now maintain life long after personality and consciousness are gone. At Hutchinson Regional Medical Center we encourage you to think about these issues.

Legal documents called advance directives are the best way to express your wishes regarding extraordinary health care measures. If you choose to make advance directives, we can provide the necessary forms. You do not need a lawyer in order to make an advance directive. However, legal advice is certainly appropriate.

What are advance directives?

Advance directives are documents that state a patient’s choices regarding treatment. They include decisions about refusing treatment, being placed on life support and stopping treatment at a point the patient chooses. Also included are requests for life-sustaining treatment.

There are several kinds of advance directives. Two that are mentioned most often are the living will and the durable power of attorney for health care. Kansas statutes recognize both a living will and a durable power of attorney for health care.

What is a living will?

A living will is a signed, dated and witnessed document that allows you to state in advance your wishes regarding the use of life-sustaining procedures.

The living will is authorized in a Kansas statute titled, “The Natural Death Act.” This statute allows any adult, at least 18 years old, to sign a form (relating to him/herself only) which states that life-sustaining procedures should be withheld or withdrawn when decision-making capacity is lost and when such procedures would merely prolong death. Medical procedures deemed necessary to provide comfort or alleviate pain are not considered “life-sustaining procedures” under the act.

What is a durable power of attorney for healthcare also sometimes known as Designation of Health Care Surrogate?

This is a document in which a person gives someone else the right to make decisions about health care for him/ her. The person who would make the decisions is known as an “agent” and can be any adult except a physician or other health care provider (including people who work, own or are directors for hospitals and other health care institutions) unless the health care provider is related by blood or marriage to the person signing the document.

It is usually recommended that you appoint someone who knows your wishes and is willing to carry them out, especially regarding your personal, religious, moral and cultural beliefs. If you are incapacitated, your health care surrogate will have the authority to make all the medical decisions regarding your health care, including decisions about when to withhold or withdraw life prolonging procedures.

If you establish Advance Directives, make sure members of your immediate family know about them and where they are located. You’ll also want to share a copy with your primary care physician to include as part of your medical records, and them provide a new copy if your directives change. Be sure to also bring a copy with you when you’re admitted to the hospital.

FAQs About Advance Directives

Why is it important for me to complete Advance Directives?
There may be times whether because of an accident, injury or illness, you may not be able to make sound decisions about your health care. However, decisions still need to be made regarding your treatment and care; directives outline who can legally speak on your behalf and see that your wishes are carried out.

Who can complete a directive?
Any person who is 18-years of age and older, as well an emancipated minor, can have Advance Directives.

When are they valid?
You will need two witnesses present when you sign your directives. Only one can be a spouse, family member or relative; your health care surrogate cannot be a witness. These documents do not need to be notarized to be legal, though some prefer to have them notarized along with any other legal documents, such as a will.

When do Advance Directives take effect in a hospital?
The Designation of Health Care Surrogate takes effect as soon as your physician deems that you are unable to make your own health care decisions. A Living Will be will be enacted only when your attending physician along with a consulting physician determine you are:

  1. Unable to make your own medical decisions and are unlikely to regain this ability.
    AND
  2. In a terminal persistent vegetative state, an end-stage condition, or in any other condition that you specified in your Living Will. A more complete definition of applicable conditions can be found in the instructions section of the Advance Directives form available for download.

How long are Advance Directives valid?
These documents are valid indefinitely, unless you have specified an expiration date on the document. They become void at the time of your death or when you have rescinded them or declared them void.

If I did not designate a health care surrogate or have a court appointed guardian, who would make the decisions on my behalf if I was in the hospital and unable to make them myself?
According to Kansas law, the following individuals would make these decisions. They are, in the order of priority:

  1. Spouse (Kansas law does not recognize common law marriages as a legal marriage contract).
  2. Adult children who are reasonably available for consultation (in person or by phone).
  3. Parent(s).
  4. Sibling(s) who are reasonably available for consultation (in person or by phone). Being the oldest child does not give that child any higher priority.
  5. Relative who has exhibited special care and concern for the patient and who has maintained regular contact with the patient and who is familiar with the patient's activities, health and religious or moral beliefs.
  6. Close Personal Friend - to qualify, the friend shall be 18 years of age or older, have exhibited special care and concern for the patient; has signed a Close Personal Friend affidavit stating he or she is a friend of the patient; and is willing and able to become involved in the patient's healthcare and has maintained regular contact with the patient so as to be familiar with the patient's activities, health and religious or moral beliefs.

When should a person make sure that a Designated Health Care Surrogate has been appointed?
Prior to your medical procedure you should appoint a designated health care surrogate. If you already have one designated, changes in marital status or within your family may require changes to your surrogate appointment as well:

  • Single
  • Newly Married
  • Divorced, or contemplating divorce
  • Separated
  • Living with a significant other
  • Wanting to designate one person from the proxy category where there are several people.

When I am admitted as a patient to Hutchinson Regional Healthcare System, will I be asked about Advance Directives?
Yes, if you are an adult or emancipated minor inpatient. When you are admitted to a nursing unit you will be asked to complete a personal health history form or your nurse will assist you. At this time you will be asked about an Advance Directives form that has a summary of Hutchinson Regional Healthcare System's policy.
If you have completed Advance Directives, please bring a copy with you to the hospital and give it to your nurse. If you would like to complete one, please let your nurse know. If you have questions after reading the instructions on the back of the Advance Directives form, you may request to speak to a chaplain, case manager or your physician.

Does a Living Will mean the person is not to be resuscitated in the event of a cardiac and/or respiratory arrest?
No, but if you do not wish to be resuscitated in the event of cardiac or respiratory arrest, you must discuss this with the attending physician so that a Do Not Resuscitate (DNR) order can be entered into your medical records. This form must be completed by you and your physician in order to be valid and take effect.

Who should I contact?

If you are interested in making advance directives or have questions, please call Guest Relations at 620.513.3866.

Just as you have a right to make advance directives, you also have the right not to make advance directives. No patient at Hutchinson Regional Medical Center shall be discriminated against or have care conditioned on whether he or she has executed advance directives.