AHCDS1 - Advance Health Care Directive Form Instructions...

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Advance Health Care Directive Form Instructions You have the right to give instructions about your own health care. You also have the right to name someone else to make health care decisions for you. The Advance Health Care Directive form lets you do one or both of these things. It also lets you write down your wishes about donation of organs and the selection of your primary physician. If you use the form, you may complete or change any part of it or all of it. You are free to use a different form. INSTRUCTIONS Part 1: Power of Attorney Part 1 lets you: name another person as agent to make health care decisions for you if you are unable to make your own decisions. You can also have your agent make decisions for you right away, even if you are still able to make your own decisions. also name an alternate agent to act for you if your first choice is not willing, able or reasonably available to make decisions for you. Your agent may not be: an operator or employee of a community care facility or a residential care facility where you are receiving care. your supervising health care provider (the doctor managing your care) an employee of the health care institution where you are receiving care, unless your agent is related to you or is a coworker. Your agent may make all health care decisions for you, unless you limit the authority of your agent. You do not need to limit the authority of your agent. If you want to limit the authority of your agent the form includes a place where you can limit the authority of your agent. If you choose not to limit the authority of your agent, your agent will have the right to: Consent or refuse consent to any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect a physical or mental condition. Choose or discharge health care providers (i.e. choose a doctor for you) and institutions. Agree or disagree to diagnostic tests, surgical procedures, and medication plans. Agree or disagree with providing, withholding, or withdrawal of artificial feeding and fluids and all other forms of health care, including cardiop- ulmonary resuscitation (CPR). After your death make anatomical gifts (donate organs/tissues), authorize an autopsy, and make decisions about what will be done with your body. Part 2: Instructions for Health Care You can give specific instructions about any aspect of your health care, whether or not you appoint an agent. There are choices provided on the form to help you write down your wishes regarding providing, with- holding or withdrawal of treatment to keep you alive. You can also add to the choices you have made or write out any additional wishes. You do not need to fill out part 2 of this form if you
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This note was uploaded on 09/08/2010 for the course ANTH 25 at San Jose State University .

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AHCDS1 - Advance Health Care Directive Form Instructions...

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