New Pennsylvania law helps define end-of-life
decision-making process
Newswise — A new Pennsylvania law helps define who
could be making your end-of-life care decisions if
you do not have a living will or health care agent.
But, according to the Pennsylvania Medical Society,
it’s still better for you to have a living will and
a health care agent.
While those who already have a living will or a
health care agent may not notice the new law, those
without – particularly their family members – will.
In the past, when a patient did not have a living
will or a health care agent, was incompetent, and
had an end-stage medical condition, doctors would
gather the patient’s family members to discuss
whether or not the patient would want certain types
of treatments such as CPR, a ventilator, or a
feeding tube.
But sometimes the patient’s family members do not
agree with one another, and disputes can happen.
Although no law may ever avoid litigation and family
disputes, Pennsylvania’s new law on end-of-life care
decision-making attempts to clear up the debate over
who will make the final decision when a loved one is
incompetent and doesn’t have a living will, health
care agent, and or guardian.
“The new law clearly defines a chain-of-command
within a patient’s family,” said Christopher M.
Hughes, MD, an intensive care specialist from
Pittsburgh, Pa., and a member of the Pennsylvania
Medical Society’s board of trustees. “For most
families, there’s not a problem, but you do
occasionally have situations in which there are
strong disagreements among family members about what
our patient, their loved one, would want.”
According to Dr. Hughes, the patient’s spouse
generally is first in line among family members to
be given the responsibility of end-of-life care
decision-making through the new law. An adult child
is next in line, followed by a parent, an adult
brother or sister, and finally an adult grandchild.
In situations where these family members do not
exist, an adult with knowledge of the patient’s
preferences and values would be designated as the
decision-maker.
But Dr. Hughes urges Pennsylvanians to take care of
matters while you are competent.
“The new law handles most situations for legal
purposes,” Dr. Hughes said. “However, it doesn’t
handle hard feelings between family members. I’d
encourage everyone to have a living will and a
health care agent who knows your wishes. And make
sure your doctor has a copy of your living will.
Communicating your wishes with your loved ones and
your doctor is the key. That’s the best case
scenario, and it will more than likely avoid family
disputes.”
Five Recommended Steps from the Pennsylvania Medical
Society
to prepare for end-of-life care
1. Talk to your doctor. Your doctor can help you
understand important medical determinations that
affect your rights. Your doctor can also explain the
good and bad features of various medical measures
and artificial life-support.
2. Decide who you want to make health care decision
for you and the powers you want this person to have.
3. Decide your wishes regarding your end-of-life and
other future care.
4. Write down your decisions and make an advance
health care directive.
5. Make your wishes known. Keep an original copy of
your advance health care directive in a safe place,
but also ask your doctors to put a copy in your
medical records. Also give a copy to your health
care agent. And be sure to talk about your advance
directive with family and friends who you expect to
attend to your needs when you can’t speak for
yourself.