Advance Directive. It is not mandatory that you have health care directive, however it is highly recommended. Without advance directive you can not communicate your wishes to the doctor
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Oregon law allows any competent adult may execute a document (health care instructions - living will - or power of attorney for health care) directing that life-sustaining procedures be withheld or withdrawn |
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Oregon Revised Statues, Chapter 127 sets forth a mandatory form for an Advance Health Care Directive. In any place in the form that requires the initials of the principal, any mark by the principal is effective to indicate the principal’s intent. Therefore, you may not change the provided form. However, you have a right not to complete other part of the form. Power of Attorney for Health Care The Power of Attorney for Health Care means a power of attorney document that authorizes an adult person to make health care decisions for the principal when the principal is incapable.The Power of Attorney for Health Care is effective when it is signed, witnessed and accepted by your attorney in fact (Agent). The health care representative (Agent) has all the authority over the principal’s health care that the principal would have if not incapable, subject to the limitations of the appointment. A health care representative who is known to the health care provider to be available to make health care decisions has priority over any person other than the principal to act for the principal in all health care decisions. A health care representative is not personally responsible for the cost of health care provided to the principal solely because the health care representative makes health care decisions for the principal. Except to the extent the right is limited by the appointment or any federal law, a health care representative for an incapable principal has the same right as the principal to receive information regarding the proposed health care, to receive and review medical records and to consent to the disclosure of medical records. In making health care decisions, the health care representative has a duty to act consistently with the desires of the principal as expressed in the principal’s advance directive, or as otherwise made known by the principal to the health care representative at any time. If the principal’s desires are unknown, the health care representative has a duty to act in what the health care representative in good faith believes to be the best interests of the principal. Execution of a valid Oregon Power of Attorney for Health Care revokes any prior power of attorney for health care. Unless the health care instruction provides otherwise, execution of a valid health care instruction revokes any prior health care instruction. A health care decision made by an individual who is authorized to make the decision under ORS 127.505 to 127.660 and 127.995 is effective immediately and does not require judicial approval. A health care representative is a personal representative for the purposes of ORS 192.518 to 192.526 and the federal Health Insurance Portability and Accountability Act privacy regulations, 45 C.F.R. parts 160 and 164. [1989 c.914 §7; 1993 c.767 §9; 2005 c.53 §1]
In your Health Care Instructions you make known to the world your desires regarding life support measures, tube feeding or artificial hydration under different health conditions you might have. Under Oregon law, individuals caring for a principal from whom life-sustaining procedures or artificially administered nutrition and hydration are withheld or withdrawn shall provide care to insure comfort and cleanliness, including but not limited to the following:
Before you start working on your Oregon Health Care Directive you need to know the following terms: “Principal” means:
“Adult” means an individual who is 18 years of age or older, who has been adjudicated an emancipated minor or who is married. “Appointment” means a power of attorney for health care, letters of guardianship or a court order appointing a health care representative. “Artificially administered nutrition and hydration” means a medical intervention to provide food and water by tube, mechanical device or other medically assisted method. “Artificially administered nutrition and hydration” does not include the usual and typical provision of nutrition and hydration, such as the provision of nutrition and hydration by cup, hand, bottle, drinking straw or eating utensil. “Attorney-in-fact” means an adult appointed to make health care decisions for a principal under a power of attorney for health care, and includes an alternative attorney-in-fact. “Health care” means diagnosis, treatment or care of disease, injury and congenital or degenerative conditions, including the use, maintenance, withdrawal or withholding of life-sustaining procedures and the use, maintenance, withdrawal or withholding of artificially administered nutrition and hydration. “Health care decision” means consent, refusal of consent or withholding or withdrawal of consent to health care, and includes decisions relating to admission to or discharge from a health care facility. “Health care facility” means a health care facility as defined in Oregon Revised Statutes 442.015, a domiciliary care facility as defined in ORS 443.205, a residential facility as defined in ORS 443.400, an adult foster home as defined in ORS 443.705 or a hospice program as defined in ORS 443.850. “Health care instruction” or “instruction” means a document executed by a principal to indicate the principal’s instructions regarding health care decisions. “Health care provider” means a person licensed, certified or otherwise authorized or permitted by the law of this state to administer health care in the ordinary course of business or practice of a profession, and includes a health care facility. “Health care representative” means:
“Capable” means not incapable. “Instrument” means an advance directive, acceptance, disqualification, withdrawal, court order, court appointment or other document governing health care decisions. “Life support” means life-sustaining procedures. “Life-sustaining procedure” means any medical procedure, pharmaceutical, medical device or medical intervention that maintains life by sustaining, restoring or supplanting a vital function. “Life-sustaining procedure” does not include routine care necessary to sustain patient cleanliness and comfort. “Medically confirmed” means the medical opinion of the attending physician has been confirmed by a second physician who has examined the patient and who has clinical privileges or expertise with respect to the condition to be confirmed. “Permanently unconscious” means completely lacking an awareness of self and external environment, with no reasonable possibility of a return to a conscious state, and that condition has been medically confirmed by a neurological specialist who is an expert in the examination of unresponsive individuals. “Physician” means an individual licensed to practice medicine by the Board of Medical Examiners for the State of Oregon. “Attending physician” means the physician who has primary responsibility for the care and treatment of the principal. “Terminal condition” means a health condition in which death is imminent irrespective of treatment, and where the application of life-sustaining procedures or the artificial administration of nutrition and hydration serves only to postpone the moment of death of the principal. “Tube feeding” means artificially administered nutrition and hydration. Limitations on Power of Attorney-in-Fact: Oregon law does not authorize an appointed health care representative to make a health care decision with respect to any of the following on behalf of the principal:
Upon learning of the revocation, the health care provider or attending physician shall cause the revocation to be made a part of the principal’s medical records. Execution of a valid power of attorney for health care revokes any prior power of attorney for health care. Unless the health care instruction provides otherwise, execution of a valid health care instruction revokes any prior health care instruction. Unless the advance directive provides otherwise, the directions as to health care decisions in a valid advance directive supersede:
Any reinstatement of an advance directive must be in writing. [1989 c.914 §9; 1993 c.571 §26a; 1993 c.767 §12] A Declaration for Mental Health Treatment This is an important legal document. It creates a declaration for mental health treatment. Before signing this document, you should know these important facts:This document allows you to make decisions in advance about certain types of mental health treatment: psychoactive medication, short-term (not to exceed 17 days) admission to a treatment facility, convulsive treatment and outpatient services. Outpatient services are mental health services provided by appointment by licensed professionals and programs. The instructions that you include in this declaration will be followed only if a court or two physicians believe that you are incapable of making treatment decisions. Otherwise, you will be considered capable to give or withhold consent for the treatments. Your instructions may be overridden if you are being held pursuant to civil commitment law. You may also appoint a person as your representative to make treatment decisions for you if you become incapable. The person you appoint has a duty to act consistently with your desires as stated in this document or, if not stated, as otherwise known by the representative. If your representative does not know your desires, he or she must make decisions in your best interests. For the appointment to be effective, the person you appoint must accept the appointment in writing. The person also has the right to withdraw from acting as your representative at any time. A “representative” is also referred to as an “attorney-in-fact” in state law but this person does not need to be an attorney at law. This document will continue in effect for a period of three years unless you become incapable of participating in mental health treatment decisions. If this occurs, the directive will continue in effect until you are no longer incapable. You have the right to revoke this document in whole or in part at any time you have not been determined to be incapable. YOU MAY NOT REVOKE THIS DECLARATION WHEN YOU ARE CONSIDERED INCAPABLE BY A COURT OR TWO PHYSICIANS. A revocation is effective when it is communicated to your attending physician or other provider. If there is anything in this document that you do not understand, you should ask a lawyer to explain it to you. This declaration will not be valid unless it is signed by two qualified witnesses who are personally known to you and who are present when you sign or acknowledge your signature. |
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