Planning in advance for your medical treatment with New York State Proxy Law, which contains a sample (usable) health care proxy form and a summary of the hospital policy
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rights as a hospital patient in New York State - specific instructions medical treatment in advance - protect your treatment wishes and concerns - Do-Not-Resuscitate (DNR) Order - Cardiopulmonary Resuscitation (CPR) |
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Your Rights as a Hospital Patient in New York StateResource: http://www.health.state.ny.usYour Right to Decide About Treatment Adults in New York State have the right to accept or refuse medical treatment, including life-sustaining treatment. Our constitution and state laws protect this right. This means that you have the right to request or consent to treatment, to refuse treatment before it has started and to have treatment stopped once it has begun. Planning In Advance Sometimes because of illness or injury people are unable to talk to a doctor and decide about treatment for themselves. You may wish to plan in advance to make sure that your wishes about treatment will be followed if you become unable to decide for yourself for a short or long time period. If you do not plan ahead, family members or other people close to you may not be allowed to make decisions for you and follow your wishes.In New York State, appointing someone you can trust to decide about treatment if you become unable to decide for yourself is the best way to protect your treatment wishes and concerns. You have the right to appoint someone by filling out a form called a Health Care Proxy. A copy of the form and information about the Health Care Proxy are available within this publication and may be printed directly from the Department of Health website at www.health.state.ny.us and click on Info for Consumers. If you have no one you can appoint to decide for you, or do not want to appoint someone, you can also give specific instructions about treatment in advance. Those instructions can be written, and are often referred to as a Living Will. You should understand that general instructions about refusing treatment, even if written down, may not be effective. Your instructions must clearly and convincingly cover the treatment decisions that must be made. For example, if you just write down that you do not want "heroic measures," the instructions may not be specific enough. You should say the kind of treatment that you do not want, such as a respirator or chemotherapy, and describe the medical condition when you would refuse the treatment, such as when you are terminally ill or permanently unconscious with no hope of recovering. You can also give instructions orally by discussing your treatment wishes with your doctor, family members or others close to you. Putting things in writing is safer than simply speaking to people, but neither method is as effective as appointing someone to decide for you. It is often hard for people to know in advance what will happen to them or what their medical needs will be in the future. If you choose someone to make decisions for you, that person can talk to your doctor and make decisions that they believe you would have wanted or that are best for you, when needed. If you appoint someone and also leave instructions about treatment in a Living Will, in the space provided on the Health Care Proxy form itself, or in some other manner, the person you select can use these instructions as guidance to make the right decision for you. Deciding About Cardiopulmonary Resuscitation (CPR) Your right to decide about treatment also includes the right to decide about cardiopulmonary resuscitation (CPR). CPR is emergency treatment to restart the heart and lungs when your breathing or circulation stops.Sometimes doctors and patients decide in advance that CPR should not be provided, and the doctor gives the medical staff an order not to resuscitate (DNR). If your physical or mental condition prevents you from deciding about CPR, someone you appoint, your family members or others close to you can decide. Patients are provided with the description of state law prepared by the State Health Department entitled "Planning in Advance For Your Medical Treatment"; the publication, "Appointing Your Health Care Agent New York States Proxy Law," which contains a sample (usable) health care proxy form; and a summary of the hospitals policy regarding the implementation of these rights. 10NYCRR, 400.21 (d) (1) (i, ii, iii) Do-Not-Resuscitate (DNR) Orders A Guide for Patients and Families What do CPR and DNR orders mean?CPR cardiopulmonary resuscitation refers to the medical procedures used to restart a patients heart and breathing when the patient suffers heart failure. CPR may involve simple efforts such as mouth-tomouth resuscitation and external chest compression. Advanced CPR may involve electric shock, insertion of a tube to open the patients airway, injection of medication into the heart and in extreme cases, open chest heart massage. A do-not-resuscitate (DNR) order tells medical professionals not to perform CPR. This means that doctors, nurses and emergency medical personnel will not attempt emergency CPR if the patients breathing or heartbeat stops. DNR orders may be written for patients in a hospital or nursing home, or for patients at home. Hospital DNR orders tell the medical staff not to resuscitate the patient if cardiac arrest occurs. If the patient is in a nursing home or at home, a DNR order tells the staff and emergency medical personnel not to perform emergency resuscitation and not to transfer the patient to a hospital for CPR. Why are DNR orders issued? CPR, when successful, restores heartbeat and breathing and allows a patient to resume his/ her previous lifestyle. The success of CPR depends on the patients overall medical condition. Age alone does not determine whether CPR will be successful, although illnesses and frailties that go along with age often make CPR less successful. Can I request a DNR order? Yes. All adult patients can request a DNR order. If you are sick and unable to tell your doctor that you want a DNR order written, a family member or close friend can decide for you. Is my right to request or receive other treatment affected by a DNR order? No. A DNR order is only a decision about CPR and does not relate to any other treatment. Are DNR orders ethically acceptable? It is widely recognized by health care professionals, clergy, lawyers and others that DNR orders are medically and ethically appropriate under certain circumstances. For some patients, CPR offers more burdens than benefits, and may be against the patients wishes. How can I make my wishes about DNR known? During hospitalization, an adult patient may consent to a DNR order orally or in writing, if two adult witnesses are present. When consent is given orally, one of the witnesses must be a physician affiliated with the hospital. Prior to hospitalization, consent must be in writing in the presence of two adult witnesses. In addition, the Health Care Proxy Law allows you to appoint someone you trust to make decisions about CPR and other treatments if you become unable to decide for yourself. Before deciding about CPR, you should speak with your doctor about your overall health and the benefits and burdens CPR would provide for you. A full and early discussion between you and your doctor will assure that your wishes will be known. What happens if I change my mind after a DNR order has been written? You or anyone who consents to a DNR order for you can revoke consent for the order by telling your doctor, nurses or others of the decision. "Your rights as a hospital patient in New York State"
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