Notice of Policy Regarding Advance Directives
This Facility requires the Policy Regarding Advance Directives notice
be signed by each patient prior to scheduled procedure in order to be
in compliance with the Self-Determination Act (PSDA) and State law and
rules regarding advance directives. Advance directives are statements
that indicate the type of medical treatment wanted or not wanted in
the event an individual is unable to make those determinations and who
is authorized to make those decisions. The advance directives are made
and witnessed prior to serious illness or injury.
There are many types of advance directives, but the two most common
forms are:
Living Wills
These generally state the type of medical care an individual wants or
does not want if he/she becomes unable to make his/her own decisions.
Durable Power of Attorney for Health Care
This is a signed, dated, and witnessed paper naming another person as
an individual's agent or proxy to make medical decisions for that individual
if he/she should become unable to make his/her own decisions.
In the ambulatory care setting, if a patient should suffer a cardiac
or respiratory arrest or other life-threatening situation, the signed
consent implies consent for resuscitation and transfer to higher level
of care. Therefore, in accordance with federal and state law, the facility
is notifying you it will not honor previously signed advance directives
for any patient. If you disagree, you must address this issue with your
physician or anesthesiologist prior to signing this form.
Forms
Policy Regarding
Advance Directives (PDF Format)
Release
of Information (PDF Format)
Ownership
Disclosure (PDF Format)
