Courts have held that every adult has a right under the Constitution of the United States and under the laws of the Commonwealth of Pennsylvania to accept or refuse medical treatment. There are many different kinds of life-sustaining medical treatment decisions that face patients. For example, the artificial delivery of nutrition and hydration, i.e., providing food and water through a feeding tube is one medical procedure which an individual may choose to accept or reject. The use of a respirator is another example. Your right to accept or refuse medical treatment continues even if you were to become incompetent or otherwise unable to make or communicate medical treatment decisions. Incompetency is the ability to understand and make treatment choices which can occur as the result of the illness, and accident, or advanced age. A physician would be responsible for determining whether a person was competent to make treatment decisions. Courts usually are not involved in these determinations.
When a person is incompetent and I unable to make medical treatment decisions, family members are usually called upon to make such decisions. In these situations, the family’s role is to help decide what medical treatment the incompetent patient would want to accept or refuse. Unfortunately, even family members do not always know what treatment a patient would want. It is particularly difficult to make these kinds of treatment decisions when there is a conflict among family members as to what the patient would have wanted or not wanted.
To help make sure that your wishes regarding medical treatment are carried out should you become incompetent, you can let others know what your wishes are. One of the best ways to do this it to put your wishes in writing and sign it. This written statement is called an advance health declaration, or a living will. The purpose of a living will is to describe the kinds of medical treatments or procedures that you want to accept and those you would want to refuse. It is your choice as to how general or specific you want to make directions in a living will.
You may want to talk to your doctor and your family before writing such a statement. Some people will also want to talk to their attorney and clergy.
Pennsylvania does not have a living will statue. A living will is a very important document. While the hospital certainly treats all living wills as important documents, the hospital uses a living will as one of several factors that play an important role in any decision concerning the termination of life-sustaining treatment. Other important factors include the input of the patient’s family, the doctor’s recommendations, and any information that the hospital has directly learned of the patient’s wishes while he or she has been at the hospital.
DURABLE POWER OF ATTORNEY
In addition to stating what treatment you would want, you may also want to ask a family member or a friend to make medical treatment decisions for you in the event you were to become incompetent. This can be accomplished by a legal document known as a “durable power of attorney.” However, it is not clear whether the Pennsylvania power of attorney statue authorizes the person appointed by you to be able to direct that life-sustaining treatments to be withheld or withdrawn. Because there are legal requirements for a “power of attorney,” as well as limitations as to the kind of powers that can be granted by it, it is best to talk with an attorney about this document.
It is possible to make an advance directive that combines both a living will and a formal durable power of attorney. In this manner, you can leave directions about what your wishes are regarding medical treatments to be carried out and also appoint another individual to make medical treatment decisions for you in line with those directions. Once again, because there are legal requirements and limitations where a power of attorney is involved, you may want o talk with an attorney about this document.
GEISINGER JERSEY SHORE HOSPITAL
At Geisinger Jersey Shore Hospital, advanced directives such as living wills, durable power of attorney, and other methods for communicating patients’ wishes regarding life-sustaining treatment are encouraged and will be considered individually by the attending/covering physician in his/her decision making process.