Our palliative care team can assist you in addressing the questions below related to your care. The explanations provided are meant to give you a better understanding of these issues.
What is Level of Treatment?
The level of treatment is simply a determination of what types of treatment the medical team should provide to a patient in light of expected outcomes. Determining the level or intensity of treatment involves balancing the burdens of a particular therapy against the benefits of that therapy or intervention to the patient. For example, all would agree that it is good to provide a treatment with a high probability of helping the patient, especially if the treatment carries a low burden in terms of pain or other hardship. But when might it be appropriate to stop life-support systems on a critically ill patient, or forego further aggressive medical treatment and choose to be kept comfortable? A competent, informed patient, working closely with the physician, should make these personal choices. If the patient is unable to make decisions, a health care decision maker should work with the physician on the patient's behalf.
What is a Health Care Decision Maker?
A health care decision maker is a person designated to make decisions with doctors or other health care providers on behalf of a patient who is no longer able to make his or her wishes known. You may designate a health care decision maker for yourself verbally by informing your nurse or physician. You may also designate a "health care decision maker" known as your "agent" with a Medical Power of Attorney or in your Living Will.
What are the issues surrounding the use of Life-Support Systems?
Decisions to accept or reject life-sustaining therapies, like other choices about medical treatment, must be made voluntarily by competent and informed patients, or if the patient lacks decision-making capacity or is unable to communicate, by another appropriately informed health care decision maker acting on the patient's behalf. This person could be a family member, legal guardian or a designated agent acting with a Medical Power of Attorney. While making these decisions can be difficult, we have many people who are here to assist you in addition to your physician. BSA has social workers, chaplains and ethics committee members are available to review a situation and to help you understand your options. Your physician or nurse can help you reach a chaplain, social worker or ethics committee member.
What is an Advance Directive?
An advance directive is a legal document that allows you to participate in decisions about the type of medical treatment that you wish at a time in the future when you may be unable to make your wishes known because of your illness. There are four types of advance directives recognized in Texas: Directive to Physicians and Family, Medical Power of Attorney, Out of Hospital Do Not Resuscitate Order, and Declaration for Mental Health Treatment.
What is the difference between a will, living will, durable power of attorney and medical power of attorney?
The "Will" and the "Durable Power of Attorney" are FINANCIAL documents. The "Living Will" and "Medical Power of Attorney" are MEDICAL DIRECTIVES.
A "Will" is a document that allocates your assets upon death. The "Durable Power of Attorney" is a legal document which gives the person you choose the power to manage your assets and financial affairs. MDACC Social Workers do not provide assistance with these two documents. Please speak with an attorney for information about the "Will" and "Durable Power of Attorney".
The "Living Will" helps you communicate your wishes about medical treatment in the future if you are unable to make your wishes known because of illness or injury. It instructs your healthcare provider to proceed or not to proceed with life sustaining treatment in the event of terminal illness or an irreversible condition.
The "Medical Power of Attorney" is document that allows you to choose someone to make healthcare decisions for you, if you are not able to make them yourself. Remember you can change these forms at any time for any reason.