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In 1990 Congress passed the Self-Determination Act, requiring hospitals to tell patients and people in their communities about their medical rights under Virginia Law. In Virginia "every human being of adult years and sound mind has a right to determine what shall be done with his own body". These rights include the right to accept or refuse care and the right to make advanced directives about their care. You can make these decisions about treatment for yourself now - and make them known to your doctor in advance - by using an advanced directive. There are two types of advanced directives: A living will, also called a "Natural Death Act Declaration", and Durable Power of Attorney for Healthcare, also known as a "health care proxy". A living will is a document that tells people how to care for you if you have a terminal condition and you cannot make decisions for yourself. A terminal condition is an incurable condition in which death is imminent. It also means a persistent, vegetative state, also called a permanent coma, even when death is not imminent. In either case, a doctor has determined that there is no hope for recovery. People who never sign a living will, but have made their wishes known in front of witnesses, are protected under the Virginia Natural Death Act. The Act lists people who can make decisions for you if you cannot make them, and have not made a living will. However, if there is someone that you would want to make decisions for you, you should name them in a living will now so the choice will be yours. Life-prolonging procedures are treatments not expected to cure a terminal condition or make you better and only prolong dying. They include hydration, nutrition by tube, machines that breathe for you, and other kinds of medical and surgical treatment. You can state in your living will that you want certain life-prolonging procedures performed on you. For example, if you want all life-prolonging procedures except food and water withdrawn, you may state that in your will. Another type of advanced directive is "Durable Power of Attorney for Health Care" or "health care proxy". This allows you to give your right to make treatment decisions to another person you name. This person can make all healthcare decisions for you, or only those on your decision list. The law prevents this person from making decisions that he or she knows do not meet with your religious beliefs, basic values and state preferences. The differences between these two types of advanced directives is that a living will only applies when you have a terminal condition and only addresses life-prolonging procedures; a durable power of attorney for health care applies to those cases, as well as situations when you can't make treatment decisions but do not have a terminal condition. It can cover any decisions you wish. Advanced directives can always be revoked after signing them, and you can always make a new one. At Wythe County Community Hospital, advanced directives are kept on file for people who want to make their wishes known to their families and health care providers. WCCH also offers an ethics consultation service, where an ethics committee will help patients and family members make decisions concerning health care. If you would like more information about advanced directives, call Wythe County Community Hospital Education at 228-0370. |
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