Understanding legal terms
Advance directives are documents written in advance of incapaciting illness(es) that state your choices about treatment, or name someone to make such choices, if you become unable to make decisions. Advance directives are a tool for you to make legally valid decisions about your future medical treatment.
Wisconsin law recognizes three documents as advance directives — the Living Will, the Power of Attorney for Health Care (POAHC) and the Do-Not-Resuscitate Order.
A Living Will is a document by which you may direct your physician not to use life-sustaining procedures or feeding tubes if you are in a terminal condition or persistent vegetative state. The term "life-sustaining procedure" is defined by Wisconsin law as follows:
Any medical procedure or intervention that, in the judgment of the attending physician, would serve only to prolong the dying process but not avert death when applied to the patient. "Life-sustaining procedure" includes assistance in respiration, artificial maintenance of blood pressure and heart rate, blood transfusion, kidney dialysis and other similar procedures, but does not include:
- a. The alleviation of pain by administering medication or by performing any medical procedure
- b. The provision of nutrition and hydration
Power of attorney for health care
A Power of Attorney for Health Care (POAHC) is a document you, the "principal," create by appointing another person, the health care "agent" to make health care decisions if or when you become incapacitated.
For more information about the Health Care Power of Attorney, click here. For a printable copy of the Health Care Power of Attorney form, click here.
A do-not-resuscitate order is a written order that directs emergency medical technicians, first responders and emergency health care facility personnel not to attempt cardiopulmonary resuscitation (CPR) on a person for whom the order is issued if that person suffers cardiac or respiratory arrest. [This form of advance directive under Subch. III of Ch. 154, Stats., has no affect regarding inpatient hospitalization do-not-resuscitate rules.] This pre-hospital do-not-resuscitate order is issued only by a physician for patients age 18 or older who meet the following criteria:
a. Have a terminal condition.
b. Have a medical condition such that, were the patient to suffer cardiac or pulmonary failure, resuscitation would be unsuccessful in restoring cardiac or respiratory function or the patient would experience repeated cardiac or pulmonary failure within a short period of time before death occurs.
c. Have a medical condition that, were the person to suffer cardiac or pulmonary failure, resuscitating that person would cause significant physical pain or harm that would outweigh the possibility that resuscitation would successfully restore cardiac or respiratory function for an indefinite period of time.
An attending physician may issue a do-not-resuscitate order only if the patient meets the above criteria, the patient (or an incapacitated patient's guardian or health care agent) requests the order, the order is in writing, the patient (or incapacitated patient's guardian or health care agent) signs the order and the physician does not know the patient to be pregnant. In addition, the physician, or a person directed by the physician, must provide the patient (or incapacitated patient's guardian or health care agent) with written information about the resuscitation procedures the patient (or incapacitated patient's guardian or health care agent) has chosen to forego and methods by which the do-not-resuscitate order may be revoked.
Health Care Agent
The person(s) you select make health care decisions for you if you are unable to make those decisions personally due to incapacity.
A patient who is at least 18 years of age.
The inability to receive and evaluate information effectively or to communicate decisions to such an extent that the patient lacks the capacity to manage his or her health care decisions. A finding of incapacity is made by two physicians or a physician and a licensed psychologist who have personally examined the patient.
A "terminal condition" is "an incurable condition caused by injury or illness that reasonable medical judgment finds would cause death imminently, so that the application of life-sustaining procedures serves only to postpone the moment of death." Two doctors, one of whom is the patient's attending physician, must personally examine the patient and certify that the patient's illness or injury is terminal.
A "persistent vegetative state" is a condition that reasonable medical judgment finds constitutes complete and irreversible loss of all of the functions of the cerebral cortex and results in a complete, chronic and irreversible cessation of all cognitive functioning and consciousness and a complete lack of behavioral responses that indicate cognitive functioning although autonomic functions continue. Two doctors, one of whom is the patient's attending physician, must personally examine the patient and certify that the patient is in a persistent vegetative state.
A medical tube through which nutrition or hydration is administered into the vein, stomach, nose, mouth or other body opening.