How Important are Advance Directives?

Filling out this document could save your life.

This summer brought news that one of the nation’s largest health insurance companies, Aetna, will be withdrawing from most Obama health care exchanges in 2017. Aetna follows United HealthCare and Humana in withdrawing, all having lost millions of dollars in the exchanges this year alone.

Obamacare regulations are forcing insurance companies to spend less money. Spending less money means paying for less care and/or talking people into asking for less care. Senior citizens, as well as those who are suffering from expensive health situations are likely targets for propaganda extolling the virtues of “less is better” when it comes to health care.

National Right to Life’s Robert Powell Center for Medical Ethics offers examples of advance care planning materials in widespread use that, it argues, often violate the principle of informed consent by selectively presenting facts in a distorted and unbalanced manner to “nudge” unwary patients to reject CPR, IV fluids, and medically assisted feeding. Other advance care planning materials, the center says, describe disabilities and illnesses in an inaccurately repugnant way so as to induce people to agree that a low “quality of life” is not worth living. The focus is on saving money rather than the patients’ best interests.

End of life treatment decision making is difficult, with scenarios impossible to foresee. Not only is it possible for pressures to be exerted to unduly hasten death, but making decisions about care [which seems like you may not want now] while healthy, may not be what is best when a later situation arises. That is why Oregon Right to Life encourages Oregonians to fill out an advance directive for health care for the purpose of appointing a trusted individual to make good health care decisions for you should you become incapacitated.

Oregon law requires that “living wills” and “durable powers of attorney” for health care decisions must be set forth on a standard form called an Advance Directive. This is the only legal document accepted by health care providers that can be used to direct a patient’s care should a person become incapacitated and unable to make decisions for himself. Before that stage is reached, Oregon Right to Life recommends that a trusted person be appointed to make those decisions for the patient.

Part B of this form is called “Appointing a Health Care Representative.” Oregon Right to Life recommends that you complete this section. Use Part B to appoint someone you trust as your health care representative to make end of life decisions for you when you are no longer capable of making those decisions for yourself.

Part C may limit the decisions your trusted health care representative can make. Oregon Right to Life encourages you to leave Part C blank.

Fill out Parts D and E to finish the authorization for your health care representative. Make sure you, your physician, and your health care representative have copies of the document.

The Physician Order for Life Sustaining Treatment (POLST) is different from an Advance Directive. Many people entering health care facilities today are told they must fill out a POLST. This not correct.

The POLST form, initially designed to decrease unnecessary health care interventions at the end of life, is being promoted as a tool for decreasing health care costs and has several limitations:

  • It becomes a physician’s order and must be followed.
  • It is simplistic and may not reflect current medical circumstances.
  • It can easily be misused.
  • It is inflexible and, in most cases, overrides any decisions the person you have designated to have power of attorney may make.

Unless you have a prognosis of less than one year to live, Oregon Right to Life discourages filling out a POLST form.

Oregon Right to Life encourages you to act today to fill out these forms so that you can be assured that, should you become incapacitated, you will receive the health care that is best for you, not an insurance company.

To download the Advance Directive, go to advance-directives-polst

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