Patient Care

Advanced Directives

An advance directive is a document that pertains to treatment preferences and the designation of a surrogate decision-maker in the event that a person should become unable to make medical decisions on their own behalf. Advance directives are generally in the form of a living will, life-prolonging procedures declaration, designation of a health care representative or proxy, and durable power-of-attorney. Advance directives can be revoked or amended at any time. This section on advance directives has been designed to help you understand Federal and Illinois laws about advance directives, and the Ingalls Same Day Surgery’s policies about these issues.

Federal Law

The 1990 Patient Self-Determination Act is a federal law that says patients must be informed of their rights under state law to make decisions about their medical care, including the right to accept or refuse medical or surgical treatment and the right to have an advance directive. The advance directive document is a way for you to communicate what kinds of medical care and treatment you do or do not want if you become unable to make these decisions for yourself.

Illinois Law

The Department of Public Health is required to make available a uniform advance directive for a do-not-resuscitate order that may be used in all settings, the statutory Living Will Declaration form, the Illinois Statutory Short Form Power of Attorney for Health Care, the statutory Declaration of Mental Health Treatment Form, and the summary of advance directives law in Illinois. (Section 2310-600 of the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois, 20 ILCS 2310-600).

In addition, federal legislation (Patient Self-Determination Act, 42 U.S.C.A. § 1396a[w] [West 1996]) requires certain providers participating in the Medicare and Medicaid programs to furnish patients with information on advance directives. The information is to be given to patients upon admission to a facility or when provision of care begins. Providers covered by this requirement include the following entities: hospitals, nursing facilities, providers of home health or personal care services, hospice programs and health maintenance organizations.

Living Will

A living will is an advance directive that allows you to specify or limit the kinds of life-prolonging procedures you wish to receive if you become terminally ill and unable to make medical decisions. It is a voluntarily executed document put into writing and signed by the person making the declaration (or his/her representative if the patient is unable to sign) and signed in the presence of at least two witnesses.

Life-Prolonging Procedures Declaration

A life-prolonging procedures declaration document is an advance directive that allows you to specify your wish to receive life-prolonging procedures that would extend life if you become terminally ill and unable to make medical decisions. This declaration must be signed and dated and witnessed by two people who are at least 18 years old and who know you well but are not related to you. These witnesses should not be your potential heirs or your health care providers, and they should not hold direct financial responsibility for your health care.

Health Care Representative

A health care representative document is an advance directive that allows you to name someone else to make your health care decisions for you should you become unable to make health care decisions. You should tell this person of your wishes about refusing or stopping care, as well as matters of more routine care. This type of advance directive can relate to any medical situation, not just terminal illness.

Power of Attorney for Health Care

A power-of-attorney for health care document is another advance directive that allows you to name someone else to make your health care decisions for you if you becme unable to make your own health care decisions. Instructions about treatment preferred or treatment to be avoided can also be included. This type of advance directive relates to any medical situation, not just terminal illness.

Advance Directive Policies at Ingalls Same Day Surgery

Ingalls Same Day Surgery Center honors Advanced Directives; however, we do not honor a ‘Do Not Resuscitate’ order. All DNR orders are suspended while the patient is in surgery and for 24 hours after surgery. Discussion with your physician regarding your DNR is essential to decide the best care for you.