Summary: General Guide to Advance Directives and Resuscitative Status -
Health care consumers and providers increasingly are discussing medical decision making and planning.
Each patient is unique in determining his or her wishes regarding treatment options in critical situations
and at the end of life. Patient information is located in a red page protector in front of in-patient chart.
Advance Directives (AD)
·An individual's legal way to document wishes for medical care before incapacitating illness/ injury.
·Consists of two distinct parts - Living Will (documents wishes concerning medical treatment) and
Medical Power of Attorney MPOA-(names another person to make health care decisions)
·We give AD form and explanatory brochure to each patient at Admitting. We have policy (#142) and
process in place to document existence of AD form and/or patient's wishes.
·The form documents wishes related to Anatomical Gift, Organ, tissue or eye donation - state law
makes it illegal for living family to make decisions against patient's expressed wishes. (Policy #98).
·MPOA = Surrogate Decision Maker. Without a MPOA state law sets the following hierarchy:
legally appointed guardian; spouse if divorce not filed, adult children, parent, adult brother or sister; and
then any other relative of patient in descending order.
·There is a repository in Medical Records that contains copies of submitted advance directive forms.
Durable DNR (Do Not Resuscitate)
·Recent Virginia law changed EMS DNR to Durable DNR which documents a physician's order for "do
not resuscitate" that is valid in all settings (including health care institutions). (Policy #79)
·This form is completed by MD with bona fide relationship (including resident MDs) with any patient