1. Advance Directives and Client Rights
Lesson 1: Advance Directives

2. Lesson 1– Advance Directives
Advance directives are legal documents that allow people to state what medical treatments they want or do not want in the event that they are unable to make decisions or communicate because of severe illness or injury.
States may differ in their laws regarding advance directives.
Advance Directives
People have the right to make decisions regarding their health care. Advance directives are legal documents that allow people to state what medical treatments they want or do not want in the event that they are unable to make decisions or communicate because of severe illness or injury.
States may differ in their laws regarding advance directives. Health care workers must comply with the laws in their state.

3. Lesson 1– Living Will
A living will is a document that allows people to state what medical treatments they want or do not want to prolong their life in the event that they are unable to make decisions or communicate because of severe illness or injury.
A living will may state that people do or do not want to have an autopsy or donate their organs.
Living Will
A living will is a document that allows people to state what medical treatments they want or do not want to prolong their life in the event that they are unable to make decisions or communicate because of severe illness or injury. For example, a living will may state that people do or do not want any of these treatments:
Surgery
Blood transfusion
Kidney dialysis
Cardiopulmonary resuscitation
Artificial respiration
Artificial nutrition and hydration
Pain medication
For example, a man’s living will states that, for religious reasons, he does not want to receive blood transfusions. Several years later, he becomes seriously ill and loses consciousness. The man’s doctor recommends a blood transfusion. Because of the man’s living will, the doctor cannot order the transfusion.
In addition, a living will may state that people do or do not want to have an autopsy or donate their organs.
A living will must be signed when a person is competent, and it must be witnessed by two adults who will not benefit from the person’s death.

4. Lesson 1– Durable Power of Attorney for Health Care
A durable power of attorney for health care is a document that allows a person, the principal, to give another person, the agent, the right to make decisions regarding the principal’s health care if the principal is unable to make decisions or communicate because of severe illness or injury.
A living will outweighs power of attorney.
Durable Power of Attorney for Health Care
A durable power of attorney for health care is a document that allows a person, a principal, to give another person, an agent, the right to make decisions regarding the principal’s health care if the principal is unable to make decisions or communicate because of severe illness or injury.
An agent may be a person’s relative, friend, or any other adult selected by the principal. An agent has the following rights and responsibilities:
Have access to medical records
Allow or deny medical treatments
Hire or dismiss health care providers
Spend or withhold funds for health care
For example, a woman gives her husband power of attorney. After an accident, she slips into a coma with no hope of recovery. Knowing that his wife would not want any medical treatments that would artificially prolong her life, the husband does not allow her to be connected to a breathing machine.
A durable power of attorney must be signed by the principal and the agent, and it must be witnessed by at least one adult.
In addition, a living will outweighs power of attorney. In other words, a living will is followed even if an agent does not agree with a principal’s decisions.

5. Lesson 1– Anatomical Gifts
The Uniform Anatomical Gift Act (UAGA) of allows people to donate their body or parts of their body after death for transplantation or medical research.
If people want to donate their body or parts of their body, they should state this clearly by filling out a donor card, giving permission on a driver’s license, joining a donor registry, or including anatomical gifts in a living will.
Anatomical Gifts
The Uniform Anatomical Gift Act (UAGA) of 1968 allows people to donate their body or parts of their body after death for transplantation or medical research. The act recognizes the legal status of people’s permission. If people do not indicate their decision prior to death, the act also recognizes the legal status of an agent’s permission in the case of durable power of attorney for health care. In the absence of power of attorney, the act recognizes the permission of a deceased person’s closest living relative, guardian, or other authorized person.
If people want to donate their body or parts of their body, they should state this clearly. To do this, they may fill out a donor card or give permission on their driver’s license. In some states, people may join their state’s donor registry. People should also include anatomical gifts in their living will and will. If people have durable power of attorney for health care, they should discuss their decision with their agent. And all people should discuss their decision with their family.
States may differ in their laws regarding anatomical gifts. To find out their state’s requirements, people should contact a local health care provider or their state government.

6. Lesson 1– Patient Self-Determination Act
Health care providers must:
Tell adult patients of their rights to make decisions regarding their health care and to have advance directives
Assist in preparing advance directives
Document patients’ decisions regarding health care and any advance directives in their medical record
Implement patients’ decisions regarding health care and any advance directives
Never discriminate against patients based on whether or not they have advance directives
Educate staff and the community on advance directives
Patient Self-Determination Act
The Patient Self-Determination Act of 1990 requires health care providers to provide information to patients about their rights to make decisions regarding their health care and to have advance directives. This information must be provided in writing. This act applies to health care providers who accept Medicare and Medicaid money.
Specifically, the Patient Self-Determination Act states that health care providers must:
Tell adult patients of their rights to make decisions regarding their health care and to have advance directives
Assist in preparing advance directives
Document patients’ decisions regarding health care and any advance directives in their medical record
Implement patients’ decisions regarding health care and any advance directives
Never discriminate against patients based on whether or not they have advance directives
Educate staff and the community on advance directives
States may differ in their laws regarding the Patient Self-Determination Act. Health care workers must comply with the laws in their state.