Advance Directive

An advance healthcare directive is a legal document that allows you to express your wishes for medical care, including your right to refuse treatment, should you become physically or mentally unable to make decisions for yourself. It also allows you to name a support person who can make decisions if you cannot speak for yourself.

Advance directives are valuable tools. They relieve your family of the responsibility – and stress – of making difficult decisions for you, and they give your healthcare providers directions for your care.

North Kansas City Hospital complies with advance directives in accordance with state law. If an NKCH healthcare professional declines to honor your wishes as they relate to your medical care, your care will be transferred to another healthcare professional.

Questions to Consider

If you were unconscious or had permanent brain damage or a terminal illness, would you want to:

• Die without pain and suffering?
• Prolong life, regardless of the chances for recovery? 
• Have your religious beliefs respected?
• Have others honor your decisions?
• Not burden your family with difficult decisions?
• Be with your loved ones at death?

Talk with family and friends, clergy, a healthcare provider, lawyer or social worker about your wishes.

Make Your Wishes Known

Use an advance directive to request or refuse treatments and express your feelings about other healthcare issues. An advance directive lets you state your preferences for:

• Cardiopulmonary resuscitation (CPR) 
• Dialysis
• Feeding tubes 
• Intravenous (IV) therapy 
• Organ and tissue donation
• Pain relief and comfort care
• Ventilators or respirators 

How to Create Your Advance Healthcare Directive

• Obtain a healthcare directive form. Although a special form is not required, those developed by a legal or healthcare professional will guide you through the complete process.
• Put your wishes in writing. Be as detailed as possible.
• Sign and date your advance directive and have it notarized, if necessary. Missouri requires that the durable power of attorney for healthcare decisions be notarized.
• Keep a card in your wallet stating you have an advance directives and where to find it.
• Give your healthcare providers copies of your medical records at the hospital and doctor’s office. If you have a durable power of attorney for healthcare decisions, give that person a copy.
• Discuss your advance directives with your physician, family, friends and designated support person. Give copies to anyone who should be notified in an emergency.
• Bring a copy of your advance directives with you whenever you come to the hospital.

Frequently Asked Questions

How is the durable power of attorney for healthcare decisions different from a regular power of attorney?

Powers of attorney refer to business and financial matters. A durable power of attorney for healthcare decisions more clearly allows you to name someone to make healthcare treatment decisions. It does not cover business or financial matters. Many people name separate representatives for business and healthcare decisions and use separate documents to do so.  The durable power of attorney for healthcare decisions addresses healthcare matters only.

Whom should I name as my representative?

Name someone who knows your goals and values, and whom you trust to carry out your wishes. You may name a family member, but it’s not required. You might choose your spouse, an adult child or a close friend. Be sure to talk with this person about your wishes in detail, and confirm that he/she agrees to act on your behalf.

Do I need an attorney to enact my healthcare directions or durable power of attorney for healthcare decisions?

No. However, you may wish to consult an attorney.

Is an advance directive the same as a Do Not Resuscitate (DNR) order?

No. A DNR is a set of written instructions from a doctor telling healthcare providers not to perform CPR.

How long will my advance directive be effective? Can my directive be changed or revoked?

Your advance directive is effective until the time of your death, or until revoked. Review your advance directive periodically. Each time you review it, date and initial the margins to indicate your directions have been well thought out. Advance directives can be revoked orally; however, it is preferable to sign and date a written revocation and destroy all preexisting copies.

When do my healthcare directions and durable power of attorney for healthcare decisions go into effect?

Your healthcare directions and durable power of attorney for your healthcare decisions go into effect only when you can no longer make or communicate your decisions. As long as you can make decisions, it is both your right and responsibility to make your own medical decisions. 

Must my doctor, representative and institution carry out my wishes expressed in my advance directives?

Yes. Healthcare providers and your representative are obligated to honor your wishes as expressed in your advance directive, as long as they comply with state law. Any provider who will not honor your wishes or the decisions made by your representative must assist in arranging your transfer to a provider who will. 

Are my healthcare directions and durable power of attorney for healthcare decisions honored if I am in another state?

By law, all adults have the right to refuse healthcare treatment. If properly enacted, your advance directive will be honored in any state.

What if I don’t have an advance directive?

Not having an advance directive puts more stress on your family and your healthcare providers. They will be responsible for making important decisions about your care – decisions that may be difficult if they do not know your wishes.

Where can I get more information?

Call North Kansas City Hospital’s Case Management Department at 816.691.5077 (ext. 5077).