Who Will Make Medical Decisions for You When You Cannot?

By:
Howard Sussman, MD, FACS, chief medical officer, St. Joseph Hospital

You are an integral part of the health care team. The doctors, nurses, physician assistants, dietitians, therapists, and technologists work with you to provide care and advice about the nature of a disease and various treatment options, allowing you to make informed decisions about your care and actively participate in following the plan of care.

Your medical decisions are made based upon your personal values, which may be due to religious beliefs, pain or discomfort, loss of control and incapacity, or based upon experience with family members’ or friends’ illnesses.

What happens when you can no longer make decisions for yourself? Who understands your values, concerns, and fears and can make decisions that reflect what you would want?

Advanced Directives are legal documents that allow you to outline your care preferences.

A Living Will allows you to express your wishes and the care you desire when you can’t. It is your opportunity to speak to your surrogate and the health care team about your concerns, fears and desires. Living Wills are not legally binding documents in New York, but are an accepted way to express your wishes.

A Health Care Proxy allows you to designate someone to act on your behalf when you are unable. You may appoint a family member or close friend. You may not appoint your physician.  The person you choose should be someone who knows your wishes and will make the same decisions you would make. It may be difficult to give this responsibility to one person in a large family; however, it is not permitted to appoint two surrogates at the same time. You may designate an alternate proxy or agent, if the original agent cannot fulfill his/her obligation.

You must give your agent permission to withhold hydration and artificial nutrition, such as tube feedings, if you would not want that kind of care.

If you don’t designate a agent through a Health Care Proxy, the person who will make decisions for you is determined through the Family Health Care Decision Act. This law specifies who has priority to be the decision maker.

Facing any illness can be frightening. The health care team will help you understand the illness, the treatments, possible outcomes and provide guidance to help you reach an informed decision about your care. Designate a Health Care Proxy who understands your wishes and whom you trust to make important and difficult decisions for you when you are unable.  Make sure your loved ones know where to find the document to avoid any confusion when the time comes to make those difficult decisions.

If you need a family practitioner, please visit www.chsli.org or call 1-855-CHS-4500.