By Sr. Adele Hofschulte
and Debby Korpela
Special to Catholic Herald’s Mature Lifestyles

Catholics believe that life is a gift of a loving God. Catholic health care upholds the dignity of life by ensuring that all people are treated with respect in regard to their wishes around their care. We believe that each of us has the right to make decisions about our own health care. These ideas come together in the creation of Advance Directives, documents in which the individual makes provision for future medical treatment decisions in the event that he or she loses decision-making capability.

Creating an Advance Directive is a responsible and loving act which upholds the ethical values of autonomy and self-determination while preventing the overuse of life-sustaining treatments. Recent events widely reported by national media reinforce the need for each of us to take up this important responsibility.

Protect your right to make medical choices that affect your life, and lessen the responsibility and stress your family may feel if faced with difficult decisions about your care. Consider completing an Advance Directive. Below we have answered some of the most commonly asked questions about Advance Directives.

What are Advance Directives?

Advance Directives are documents which set forth your choices with regard to medical treatment, or name someone to make decisions for you regarding your medical treatment, in the event you are unable to make such decisions for yourself. These documents are called Advance Directives because you complete and sign them ahead of time, so your doctor or other health care provider will know your wishes about medical treatment. Advance Directives enable you to make legally valid decisions about your future medical care.

Two types of Advance Directives are provided for under Wisconsin law: Declaration to Physicians (Living Will) and Durable Power of Attorney (DPOA) for Health Care.

What is a Living Will?

A Living Will is a document informing health care providers of your wishes about life-sustaining treatment in cases of a terminal condition or persistent vegetative state.

When does a Living Will go into effect?

A Living Will goes into effect when: - your doctor feels you are no longer able to make your own health care decisions; and - your doctor and one other physician have determined that you are in a persistent vegetative state, or that you have a terminal condition and that life-sustaining procedures will only delay your death.

What is a Durable Power of Attorney for Health Care?

DPOA is a document, which you sign, as a competent adult, designating one or more persons to make health care decisions on your behalf, should you become unable to make those decisions. The person chosen to act on your behalf is called a “health care agent.”

Who can be a “health care agent”?

Anyone of sound mind, who is at least 18 years old, may act as your agent, except for: - your health care provider (or his/her spouse), unless he/she is a relative; - an employee of your health care provider or of the health care facility where you are a patient (or a spouse of the employee), unless he/she is a relative.

When does the agent have a right to make health care decisions on my behalf ?

A health care agent exercises authority after two physicians, or a physician and a licensed psychologist, personally examine the person and determine that he/she is incapacitated and sign a statement to that effect. This authority is discontinued when two physicians determine that you are again capacitated and able to make your own decisions.

How will my health care providers know that I have Advance Directives?

All Wisconsin hospitals, nursing homes, home health agencies and other health care organizations must ask if you have Advance Directives when you are admitted. If you have an Advance Directive, they must see that it is made part of your medical record. Give copies of the documents to your agents and to one or more of the following: spouse and/or other family members; your doctor(s); and your lawyer.

What happens if I do not have an Advance Directive?

You will receive medical care even if you do not have any Advance Directives. However, if you do have an Advance Directive, there is a greater chance that you will receive treatment according to your wishes. If you cannot speak for yourself and have no Advance Directive, your health care providers will generally look to your family or friends for care decisions. If your health care provider or facility is unsure, if your family members cannot agree, or if you need long-term care, the court will appoint a guardian to make care decisions for you.

Do I need witnesses to sign my Advance Directive documents?

Yes. Forms for both documents need to be signed by two witnesses who are at least 18 years of age. An individual is excluded as a witness, if at the time of the execution of the document, he/she is: - related to you by blood, marriage or adoption; - your spouse or your heir; - directly financially responsible for your care; - a health care provider serving you, or an employee of a health care provider serving you (chaplains and social workers are not excluded and can witness); - an employee of your inpatient health care facility (chaplains and social workers are not excluded and can witness); - your health care agent.

Can I change my mind after I have signed an Advance Directive?

You can cancel, revoke or revise an Advance Directive at any time while you are still capable of making decisions.

Where can I get Advance Directive forms?

The VIP Coordinators at each Covenant Healthcare hospital have forms and are willing to sit down and advise you on the process; call (414) 447-3850. To download a copy of the Advance Directive form put together by the End of Life Coalition, which combines DPOA and Living Will information, visit us on the Web at www.covenantseniors.com

(Sr. Hofschulte and Korpela are Covenant Senior VIP coordinators, Covenant Healthcare.)