Vermont Advance Health Care Directive means a written document voluntarily executed by a declarant in accordance with the requirements of Vermont Health Care Law
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Advance Directives for Health Care And Disposition law: any adult may execute Directive conbines a Living Will and Health Care Power of Attorney, governing the withholding or withdrawing of life-sustaining treatment |
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Vermont adopted new advance directives law that went into effect on September 1, 2005. The state of Vermont recognizes the fundamental right of an adult to determine the extent of health care the individual will receive, including treatment provided during periods of incapacity and at the end of life. The new Advance Directives for Health Care And Disposition law can be found at Vermont Statutes Annotated (V.S.A.), Title 18, Chapter 231, Sections 9700-9720. (http://www.leg.state.vt.us/statutes/sections.cfm?Title=18&Chapter=231) A new Advance Health Care Directive replaces the two existing forms: the Living Will and the Durable Power of attorney. "Advance directive" means a written record which may include appointment of an agent, identification of a preferred primary care clinician, instructions on health care desires or treatment goals, and an anatomical gift, disposition of remains, and funeral goods and services. The term includes documents designated under prior law as a durable power of attorney for health care or a terminal care document. The new directive consists of four parts: Part 1 of the new form replaces old Power of Attorney – it allows you to name an agent to make health care decisions for you if you become unable to make them on your own. You may name more then one agent and alternate agents. Your agents have to be trusted people, and they have to be familiar with your values and religious preferences. You need to notify them in advance that you want to name them as your agents and they need to agree to act as such. In Part 2 (known as a Living Will) of the form you state your wishes in regards to medical treatment that may be necessary to keep you alive if you are “balancing” between life and death and unable to communicate your wishes at the time of illness. Part 3 allows you to express you wishes regarding organ donation (anatomical gift). Part 4 allows you to state you desires regarding autopsy and funeral arrangements. Two witnesses You must sign and date this form in the presence of two witnesses. Your witness MUST NOT be:
After your Advance Health Care directive is signed and acknowledged you should give a copy of the form to your agent(s), to your physician (hospital), and to your family or friends, or to keep it in a place accessible to your relatives in case of need. Revocation If you later decide to revoke the Directive, all old copies must be destroyed. Below are important definitionsdefinitions that you might see in our Health Care Directive Form: Principal means an adult who has executed an advance directive. Agent means an adult with capacity to whom authority to make health care decisions is delegated under an advance directive, including an alternate agent if the agent is not reasonably available. The agent shall have the authority to make any health care decisions on the principal's behalf that the principal could make if the principal had capacity. Unless otherwise specified in an advance directive, an agent or guardian shall have the same rights a principal with capacity would have to:
Capacity means an individual's ability to make and communicate a decision regarding the issue that needs to be decided. An individual shall be deemed to have capacity to appoint an agent if the individual has a basic understanding of what it means to have another individual make health care decisions for oneself and of who would be an appropriate individual to make those decisions, and can identify whom the individual wants to make health care decisions for the individual. An individual shall be deemed to have capacity to make a health care decision if the individual has a basic understanding of the diagnosed condition and the benefits, risks, and alternatives to the proposed health care. Clinician means a medical doctor licensed to practice in the State of Vermont, a licensed osteopathic physician, a licensed advance practice registered nurse, and a physician's assistant certified pursuant to section 1733 of Title 26 acting within the scope of the license under which the clinician is practicing. Commissioner means the commissioner of the department of health. Do-not-resuscitate order or "DNR order" means a written order of the principal's clinician directing health care providers not to attempt resuscitation. DNR identification means a document, bracelet, other jewelry, wallet card, or other means of identifying the principal as an individual who has a DNR order. Guardian means a person appointed by the probate court who has the authority to make medical decisions. Health care means any treatment, service, or procedure to maintain, diagnose, or treat an individual's physical or mental condition, including services provided pursuant to a clinician's order, and services to assist in activities of daily living provided by a health care provider or in a health care facility or residential care facility. Health care decision means consent, refusal to consent, or withdrawal of consent to any health care. Nutrition and hydration administered by medical means is the provision of food and water by means other than the natural ingestion of food or fluids by eating or drinking. Natural ingestion includes spoon feeding or similar means of assistance; HIPAA means the Health Insurance Portability and Accountability Act of 1996, codified at 42 U.S.C. § 1320d and 45 C.F.R. §§ 160-164. Informed consent means the consent given voluntarily by an individual with capacity after being fully informed of the nature, benefits, risks, and consequences of the proposed health care, alternative health care, and no health care. When your advance directive comes into effect: An advance directive regarding health care shall become effective:
Upon a determination of need by the principal's clinician, or upon the request of the principal, agent, guardian, ombudsman, health care provider, or any interested individual, the principal's clinician, another clinician, or a clinician's designee shall reexamine the principal to determine whether the principal has capacity. The clinician shall document the results of the reexamination in the principal's medical record and shall make reasonable efforts to notify the principal and the agent or guardian, as well as the individual who initiated the new determination of capacity, of the results of the reexamination, if providing such notice is consistent with the requirements of HIPAA. An advance directive regarding disposition of the principal's remains shall become effective upon the death of the principal. When a medical provider may refuse to follow advance directive: A medical provider may refuse to follow an advance directive if it will cause the practitioner to violate criminal law or professional standards; or if they have moral, ethical or other conflicts. If such conflict arises, health care practitioners may have professional obligations to continue to provide care until another provider is found. Advanced directives executed after a patient is admitted to the hospital must be accompanied by a statement that the nature and effect of the advance directive has been explained to the patient. This statement can be from ombudsman, member of clergy, attorney licensed to practice in Vermont, probate court designee, or hospital designee. Doctors and other health care providers may not provide or withhold medical care over a patient’s objection, unless exceptions apply. These exceptions are:
The Vermont Advance Directive Registry (VADR) is a secure, web-based database to which individuals may submit, at no charge, an advance directive or an Advance Directive Locator (information regarding the location of an advance directive), and other documents which amend, suspend, or revoke an advance directive. VADR is a voluntary database. Registrants who voluntarily use the VADR system have a responsibility to keep the VADR system informed and updated about any changes to their Advance Directive. The Vermont Advance Directive Registry located at: Vermont Advance Directive Registry c/o USLWR 523 Westfield Ave., P.O. Box 2789 Westfield, NJ 07091-2789 Phone: 1-800-548-9455 Fax: 1-908-654-1919 If there is anything about this Vermont Advance Health Care Directive that you do not understand, you should ask a lawyer to explain it to you. You should talk with your family, your health-care professional, and any agent or attorney-in-fact that you appoint about your health care decision to make one or more advance directives. If they know what health care you want, they will find it easier to follow your wishes. If you cancel or change the Vermont Advance Health Care Directive in the future, remember to tell these same people about the change or cancellation. |
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