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Advance Directives: What They Are and Who Needs Them

Although it is a subject most individuals want to avoid, it is extremely important to talk to your family about your end-of-life health care. By default, physicians continue treating individuals to keep them alive for as long as possible, because without consent from the patient or surrogate, they usually do not switch to a comfort care approach to treatment. In these instances, an extremely difficult decision of choosing a treatment approach is left to family members. Family members can feel the stress and responsibility of making the right decision for their relative complicated by uncertainty about what the person would want, and feelings of grief and/or guilt. Understanding our wishes and values helps family members who are left to make decisions when we are no longer able.

North Carolina and federal laws give every competent adult the right to make their own health care decisions.  As important legal documents, advance health care directives describe the medical care you want. They help your family, friends and doctors carry out your wishes even if you’re unable to communicate them. Preparing advance medical directives gives adults the opportunity to declare in advance what medical treatment and decisions they want for themselves if they are unconscious or otherwise unable to express their wishes during a serious illness or terminal situation.

Advances in medical technology have made it possible to keep people alive well beyond the point where their lives may have meaning and quality to them. Patients who can’t communicate their wishes regarding their medical care may be kept alive by heart-lung resuscitation, breathing machines, artificial feeding and other methods.  Many people view this as postponing death rather than sustaining life. This is why advance directives are so important.

Advance medical directives should be discussed in depth with family to establish full understanding of the wishes, beliefs and values of the individual preparing the documents.  Cone Health supports a competent adult’s right to make decisions to accept or refuse medical, surgical or mental health treatment, and encourages individuals in the community to prepare advance medical directives.

Cone Health Department of Spiritual Care and Department of Social Work are dedicated to patient advocacy and educating families in the community about the importance of advance medical directives.

Spokesperson Background:

Bob Hamilton, M.Div., BCC, has been the director of Cone Health’s Department for Spiritual Care and Wholeness since 1979.  Hamilton is also a long-standing member of the Cone Health Ethics Committee, which is focused on patients’ rights. He is a 1969 graduate of Duke University Divinity School and earned a Master of Divinity from Episcopal Seminary in Virginia in 1970.

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