(CENTENNIAL, COLO.) As much of the community, state, country, and world focuses on the novel coronavirus pandemic, a renewed interest in advance care planning, and advance directives specifically, has also resulted. Advance directives are instructional documents for end of life care that any adult, who can express or make their own decisions, can fill out. These documents include a Medical Durable Power of Attorney (MDPOA), a Living Will, and a CPR Directive. All three documents only pertain to medical treatment.
"Advanced directives and end of life care planning are subjects that can profoundly touch the lives of us all. One’s ability to live a full human life and to reflect the unique dignity that belongs to each person is core to Centura Health’s commitment to caring for the whole person,” stated Patrick Gaughan, Centura Chief Values Integration Officer. “As a community of compassion, love, and support, understanding an individual’s preferences and goals of care helps our clinical team honor the patient’s wishes, allowing better patient care with utmost respect for that person’s life.”
The MDPOA designates a decision maker that the person trusts to be able to make decisions if the person filling out the document is not able to make them on their own. Instances of a lack of decisional capacity could be anything from the person being on a ventilator to a person who has diminished mental capacities. This document is especially relevant in the state of Colorado, because there is no Next of Kin hierarchy in the state, when it comes to medical decision making. This means that, legally, the next of kin has no more right than a friend or other family member to make medical decisions for a patient who is non-decisional, unless that person is designated as an MDPOA.
The Living Will instructs medical staff, family members, and decision makers on a person’s wishes regarding food and fluids as well as life sustaining measures, if a person is declared to have a terminal illness or is in a persistent vegetative state. It also offers a space for a person to declare wishes regarding the donation of anatomical gifts.
The CPR Directive outlines a person’s desire to not receive CPR, either by emergency medical technicians or at a hospital. As such, it is recommended that a person have this directive in plain view for emergency services to see. This directive only pertains to CPR, and a person with this directive would still receive medications and medical care to aid lifesaving or comfort measures. This document needs to be signed by a person’s primary care physician.
These three advance directives, outlined above, are the legal advance directives in the state of Colorado. Because of the spread of the novel coronavirus, hospitals and patients have expressed a renewed interest in this form of advanced care planning. While these documents are helpful for medical staff to have on hand, they are completely voluntary, and a person without advance directives will be treated in the same manner as one with advance directives. The importance of these documents is for your voice to be heard through the people you trust and for your wishes to be clearly stated in a time of uncertainty.
In a discussion on advance directives during these times, it is also important to speak to the idea of “gifting.” This term refers to person’s desire to relinquish their right to ventilator, so that another person might benefit from this life-saving medical care. In any conversation about such measures, it will be important to make clear your desires on a document such as the MDPOA or Living Will. Those clarifications should include instances in which you are willing to give up your ventilator as well as instances where you may not be willing. While the gift is a precious one, like any other end of life decision it is one that should be made with clarity of intention and with the input of those you trust.
The importance of these decisions for every person, not just those who think they are approaching the end of life, has become all the more clear amid a virus that does not discriminate. While not everyone will fill out an advance directive in the coming days, this information may help in starting a conversation on these kinds of decisions and how they can help empower loved ones to make decisions.
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Centura Health connects individuals, families and neighborhoods across Colorado and western Kansas with more than 6,000 physicians and 21,000 of the best hearts and minds in health care. Through our 17 hospitals, two senior living communities, neighborhood health centers, physician practices and clinics, home care and hospice services, and Flight For Life® Colorado, our caregivers make the region’s best health care accessible. We’re on a mission to build flourishing communities and whole person care. We’re Centura Health, and we’re your dedicated health partner for life. For information on Centura Health or any of the facilities in our network, please visit the Centura Health website.
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