News release: National

March 29, 2005

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Call Dena Durkin, 626-381-5845

Kaiser Permanente Offers Free Information Online on Living Wills, Advance Directives, and Medical Powers of Attorney

Advance planning can help family members make decisions at end of life

Oakland, CA--Kaiser Permanente announced today that consumers can obtain information about advance directives on its website – www.kaiserpermanente.org – and thereby clarify end-of-life decision-making.

As a public service to members and non-members alike, Kaiser Permanente is highlighting the advance directives pages of its website, which provide visitors with thorough guidance about end-of-life decisions, written with the consultation of experts in medicine and bioethics. The site addresses a full range of related topics, including the type of advance directives available and the various ethical issues surrounding such decisions. To learn more, consumers should go to http://www.kaiserpermanente.org/, click on "Search Our Site" and enter the search term “advance directive” in the keyword window.

“It’s critical that people consult with loved ones and their doctors, and then formalize their wishes,” said Kate Christensen, MD, Medical Director, Kaiser Permanente Internet Services Group. “An advance directive is crucial for having control over your own medical care even if you become unable to make decisions or communicate.

“Patients should not wait for a doctor to bring up the subject of an advance directive,” Dr. Christensen added. “They should consider end-of-life issues while they’re healthy enough to consider and communicate their wishes.”

Living wills and medical powers of attorney are types of advance directives. A living will, also called a treatment directive, documents personal wishes about end-of-life medical treatment in case decision-making or communication abilities are lost. It outlines general preferences for medical treatment, such as what measures should be taken if the patient is hospitalized with a serious illness. A person must be a competent adult (having full abilities to make decisions for him or herself) in order to fill out an advance directive.

Patients have the right to stop or refuse any medical treatment, even if doing so results in death. A living will protects this right even if a patient is no longer able to speak. The law does not make a distinction between stopping treatment and refusing treatment. However, laws vary from state to state regarding when a person may refuse life support through an advance directive.

A medical power of attorney is a legal document that lets patients appoint someone (usually called a health care agent or health care proxy) to make medical treatment decisions for him or her, not only at the end of life but any time the individual is unable to communicate their wishes. Laws vary from state to state; some states limit the agent's authority, so it is important to become familiar with the laws in your state. A patient’s health care agent can use the information in a living will as well as what he or she knows about the patient personally to make decisions about medical treatment. The patient can also add their own written treatment preferences and values regarding life-prolonging medical interventions.

Patients can be sure that their wishes will be understood with these documents. This also spares loved ones the burden of making difficult decisions on someone else’s behalf without knowing their desires. If a patient has no living will or health care agent, end-of-life decisions may be in the hands of doctors or the court system.

The http://www.kaiserpermanente.org/ Health Encyclopedia website offers a checklist of issues to consider, including the type of health care and medical procedures a patient might want, the four steps in preparing an advance directive, and information about how to become an organ donor. Ethical issues – like artificial hydration and nutrition, and CPR and mechanical ventilation – are also addressed on the website.