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Advance Directives

Your right to make decisions about medical treatment is important - and both Federal and State Law, and the Centers for Medicaid and Medicare require that hospitals pay attention to your wishes.  The following information is only an overview.  We recommend you discuss medical decisions and your wishes with your physician, family members, friends, and lawyer. Please refer to the websites listed below for additional information.  Documenting your medical decisions and wishes about medical treatment through a written Advance Directive is the best way to ensure your wishes are recognized and followed.

What is an Advance Directive?
In Colorado, there are three types of documents that are recognized by the laws of the State of Colorado and qualify as "advance medical directives".  Those three documents are: CPR directives, living wills, and Medical Durable Power of Attorney (MDPOA).  Each of those documents assist health care providers with information regarding your wishes for medical treatment should you be unable to make decisions at the time treatment is needed.

Colorado CPR Directive
A Colorado CPR Directive is a document that is signed by both you and your doctor that indicates your desire NOT to have cardiopulmonary resuscitation initiated should your breathing stop or heart stop beating.  This type of directive is usually used by individuals who are elderly who are living with chronic illnesses or individuals who have critical, life threatening or terminal illnesses.
Living Will
A Living Will is a document that has written instructions that state your wishes regarding artificial life support if you have a terminal condition or are in a persistent vegetative state and are unable to tell your doctors what you would want regarding medical treatment.

Medical Durable Power of Attorney
A MDPOA is a document you sign naming someone to make your healthcare decisions if and when you are not able to do so.  The person you name is called your healthcare agent.

Are there any other documents recognized in Colorado that will inform healthcare providers of my wishes for medical treatment?
Yes - a MOST document (Medical Orders for Scope of Treatment)

This form is a one page, two- sided document that summarizes in check-box style choices for key life-sustaining treatments including CPR, general scope of treatment, antibiotics, and artificial nutrition and hydration. For each type of treatment, you may refuse treatment, request full treatment, or specify limitations. The MOST is primarily intended for use by chronically or seriously ill persons in frequent contact with healthcare providers, or already living in a nursing facility. It is completed by you or your authorized decision maker along with a healthcare provider who can explain what each of the choices mean.  Then it is signed by you (or your agent/proxy) and a physician, advanced practice nurse or physician's assistant.  When it is signed, it becomes a medical order set, not an advance directive.

The MOST is honored in any setting: hospital, clinic, day surgery, long term care facility, assisted living residence, hospice, or at home.

Important Questions

Who decides about my treatment when I am in the hospital?
You always have the right to choose what treatment you will have, and what treatment/interventions you do not want.  Your decisions should be based on information and advice your physician and the healthcare team provide for you.  You can say "Yes" or "No" to any treatment -  even if that treatment might save your life or keep you alive longer. Your physician is required to inform you about your medical condition  - and to tell you about the options for treatment.  The benefits, risks and side effects of suggested treatments are a part of the information you should receive.  Often there are multiple options for treatment and the conversation between you and your physician is important.  You have the right to decide.

If I am too ill to decide and can't make decisions for myself - who makes those decisions? 
If you have identified a health care agent through a  Medical Durable Power of Attorney, that person will make medical decisions on your behalf.   If you have not identified a health care agent, the physician and hospital staff will work with your family and other "interested parties" to identify a proxy decision-maker who will make those decisions on your behalf. 

What if I change my mind about any of my advance directives?
You can cancel or change your living will at any time. You can do this by destroying it, by signing a statement that you no longer want it, or you may prepare a new one. If you cancel or change your living will, you should tell your family, your doctor, and anyone who has a copy of it that it has been canceled or changed.

Do I have to fill out one of these forms?
No, you don't have to fill out any of these forms if you don't want to. You can just talk with your doctors and ask them to write down what you've said in your medical chart. And you can talk with your family. But people will be clearer about your treatment wishes if you write them down and your wishes are more likely to be followed if you write them down.

Will I still be treated if I don't fill out these forms?
Absolutely. You will still receive medical treatment. The purpose of this information is to help you understand that if you become too ill to make decisions, someone else will have to make them for you and to give you the opportunity to clarify your desires about your treatment and the person who can make medical decisions on your behalf.  

All of us at Centura Health want our patients to understand their rights to make medical treatment decisions. Centura Health complies with Colorado laws regarding advance directives. We do not discriminate against anyone based on whether or not he or she has completed an advance directive.


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