1. Center for Self Advocacy Leadership Partnership for People with Disabilities Virginia Commonwealth University The Partnership for People with Disabilities is a university center for excellence in developmental disabilities at Virginia Commonwealth University. VCU is an equal opportunity/affirmative action university providing access to education and employment without regard to age, race, color, national origin, gender, religion, sexual orientation, veteran’s status, political affiliation or disability. If alternative formats of this document are needed, please contact the Partnership for People with Disabilities at 804/828-3876 or 800/828-1120 (TDD Relay). This project is funded by grant number 90DN0226 from the Administration on Developmental Disabilities, US Department of Health and Human Services. The contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not infer endorsement by the Federal government. Please include this disclaimer when copying or using all or any part of the materials in dissemination activities. www.VirginiaSelfAdvocacy.org

2. YOUR RIGHT TO DECIDE Understanding Living Wills

3. Under Virginia law, citizens have the right to make decisions about their medical care. Health care institutions are required to tell patients and the people in the community about these rights.  the right to accept or refuse care  the right to make “advance directives” about future medical care. Patient Self-Determination Act

4. How Do I Exercise My Health Care Rights? Under Virginia law…every human being of adult years and sound mind has a right to determine what shall be done with his/her own body.

5. What Happens if I Cannot Give My Consent? If you are an adult, under a Virginia law called the Health Care Decision Act  you may sign a document that makes your choices about treatment known to your doctor and family in advance.  you can name someone you trust to make these decisions for you if you become unable to express your wishes yourself. This is called an “advance directive.”

6. How Do I Make My Choices About Life-Prolonging Treatment Known? There are two types of decisions about your health care in an Advance Directive. Living Will Medical Power of Attorney

7. Living Will when you have a terminal condition (an incurable condition in which death is imminent). when you are in a permanent coma, even when death is not imminent. when a doctor has determined that there is no medically reasonable hope for recovery.

8. What are “Life-Prolonging Procedures?” Treatments that aren’t expected to: cure a terminal condition make you better Life-prolonging procedures do not include treatments needed to make you comfortable or to ease pain. Examples are hydration (water) nutrition (food) by tube machines that breathe for you

9. Medical Power of Attorney If you do not have a terminal condition, the Health Care Decisions Act permits you to name someone to make treatment decisions, (accepting or refusing medical care) for you if at some point you cannot make them yourself.

10. Responsibilities Dictated by the Medical Power of Attorney The person named the Medical Power of Attorney can make all health care decisions for you that you could have made for yourself if you were able, whether or not you are terminally ill. You can also name a person who will see that your organs or your body are donated as you wish, after your death.

11. When is the Living Will Followed? The Living Will is only followed when you have a terminal condition and only deals with life-prolonging procedures.

12. When is the Medical Power of Attorney Followed? The Medical Power of Attorney covers the times when you could use a living will and also covers situations where you can’t make treatment decisions for yourself but do not have a terminal condition, such as a coma brought on by an accidental injury.

13. Will my Advance Directive be Followed in an Emergency? If you have an emergency and cannot make your wishes known, emergency medical personnel (rescue squads or ambulance teams) cannot follow your wishes in an advance directive.

14. If you have a terminal or serious condition, under certain circumstances, you can make decisions in advance about refusing one type of emergency medical care – resuscitation if your heart stops beating or you stop breathing. You do this by having your doctor complete a “Do Not Resuscitate Order” for you on a form approved by the state. The doctor may write this order to be followed in a hospital or nursing home. Will my Advance Directive be Followed in an Emergency If I Cannot Make My Wishes Known?

15. If I Die Because I Refused Life-Prolonging Treatment Under the Health Care Decision Act, Will my Death be Considered Suicide? NO! The Health Care Decision Act specifically says that, if it is followed and the patient dies, the death is not suicide. Following the Act will not void a life insurance policy even if the policy says otherwise.

16. Must an Advance Directive be in Writing? NO! This advanced directive can be done orally in front of witnesses.

17. Must I Have an Advance Directive? NO! An advanced directive is just one way of being sure your doctors and your loved ones know what health care you want when you can’t tell them yourself.

18. What Happens If I Can’t Make Decisions and I Have No Directive? Virginia law lists persons such as guardians or family members who may make decisions about your medical care even if you have no advance directives. If no listed person is available to decide for you, a judge can decide what treatment is best.

19. Do I Need a Lawyer to Help Me Make an Advance Directive? NO! A lawyer is helpful, but you do not have to have a lawyer prepare either type of advance directive.

20. What If I Change My Mind After I Sign an Advance Directive? You Can Revoke It! If you want to, you can make a new one. If you are a patient or resident in a health care facility, tell your doctor or nurse that you want to revoke or change your advance directive.

21. How Will My Doctor Know I Have an Advance Directive? Hospitals and other health care facilities must ask patients or residents if they have an advance directive, and if so, must see that a patient’s or resident’s medical records shows that they have one. Make sure your doctor, and anyone else you think needs to know what medical treatment you do or don’t want.

22. Where Can I Go For More Information About Advance Directives? There are many sources of additional information on advance directives, including your local hospital. You may wish to talk this over with your physician and your lawyer.

23. THANK YOU!