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DianaNotary
California
171 Posts |
 Posted - 04/23/2013 : 4:53:02 PM
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those are the instructions for the medical personnel!
not for the notary! :)
the notary is just doing it's duty of a public official and making sure that indeed the person who gave this instructions is the person who appeared before the notary and this was his/her wish and in fact he/she is the one signing the document!
http://www.DianaNotary.com |
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michael@925notary.com
California
0 Posts |
Posted - 04/22/2013 : 10:13:21 AM
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Do Not Resuscitate (DNR)
How do you tell people what you really want?
In early March, a story and controversy surrounding the death of an 87 year-old woman who did not make her end of life wishes known in writing was covered in the news. The article by Lisa M Krieger, “CPR Flap Could Have Been Avoided” in the San Jose Mercury News discusses an important form which many people do not know about or confuse with an Advanced Health Care Directive.
Should you become unconscious and unable to choose not to accept certain medical procedures, paramedics and doctors are not required to follow a DNR for in your wallet or language in the standard form use to name an agent for Health Power.
If you are terminally ill or frail elderly, there are three documents that will allow someone you choose to help you in your final hours. Otherwise, the hospital, doctors, paramedics and all other persons will follow standard medical protocol to keep your body functioning.
The Advanced Health Care Directive
Many people think an Advanced Health Care Directive will be sufficient. The purpose of this document is to name a person who can make health decisions for you when you are unable to do so. This is why the hospital wants one on file when you are admitted. Doctors and medical personnel cannot make this decision for the patient. While important, since the Advanced Health Care Directive is prepared by an attorney not a doctor, paramedics and emergency personnel do not need to follow any particulars included on this form. In addition, in an emergency there is not
time for them to read a legal manifesto.
Still, everyone over the age of 18 should have one. It is best if prepared by an attorney with estate planning package, but the State of California also offers a free form at: http://ag.ca.gov/consumers/pdf/ProbateCodeAdvancedHealthCareDirectiveForm-fillable.pdf
The HIPAA Authorization Release
As people age or when they are ill, it can become difficult to manage health care matters – from remembering and getting to doctor appointments to asking the doctor pertinent questions. If you have ongoing health issues, are terminally ill, or elderly, you should also consider signing a HIPPA release form to allow your health agent or another designated person to speak with your doctors about your health care needs. This can be given to more than one person and it is used even while you are competent and able to make your own decisions, so that someone else may also speak with your doctors. In the event that you need assistance with health care issues, a HIPPA release form is the only way that someone else can discuss your health need s with the medical community.
The Physician Order for Life Sustaining Treatment or “POLST”
The medical community has developed a solution to help people discuss their end of life wishes in detail with their doctor. It is one page, printed on pink pager and signed by your treating physician. I tell my clients to posit it on an entry wall or bedroom door so paramedics and others can see it. This allows the paramedics to not perform CPR, should that be your wish.
Otherwise, once CPR is started and a person receives oxygen, the heart can continue even when the brain is no longer working. Once emergency resuscitation is started, only a POLST or a decision the named Health care agent can stop normal ICU and emergency life sustaining treatments.
You may contact me at michael@mdpfiduciary.com if you would like to see samples of the POLST form or HIPPA Release form.
As a notary and licensed professional fiduciary, I hope that you find this information helpful, both personally and professionally.
Michael Prilutsky |
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Sue
Texas
22 Posts |
Posted - 04/07/2013 : 11:04:44 AM
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| Good point, middleVT. |
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middleVT
Afghanistan
38 Posts |
Posted - 04/07/2013 : 07:02:31 AM
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Looking around the Internet, I found that some states, such as Texas and Kentucky, have DNR forms that can be completed just by an adult and witnesses and/or a notary, without a physician's signature. Those forms also have no requirement that the signer be suffering from a terminal illness. I think allowing DNRs for healthy people without a physician's signature was a poor decision by the legislatures of those states. It confuses emergency medical personnel, because it goes against the national curriculum for EMS providers; imagine if Texas redefined the phrase "common cold" to include influenza. Also, it raises ethical issues that might lead out-of-state EMS providers to refuse to honor DNRs from states with these loose requirements.
It might also expose out-of-state medical providers to liability if they did honor it; if DNR means something different in Texas than it does in Oklahoma, and Oklahoma law orders Oklahoma EMTs to honor DNRs, but a Texas DNR isn't what Oklahoma means by a DNR, then what?
middleVT |
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Christine
Oklahoma
21 Posts |
Posted - 04/07/2013 : 06:26:52 AM
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Yes! As a 3-time cancer survivor/THRIVER, I have had one in the past. Anne McBride is perfectly on point and correct for most of us as it is an emotional time. The written directions made my wishes clear and easy to implement in the event that my time of transition arrived . . . :D
Christine Oldham BS PMP CNSA |
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Sue
Texas
22 Posts |
Posted - 04/06/2013 : 2:23:03 PM
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| No one in my extended family that I know of has ever had any such document. As for my immediate family, including my mother and siblings, we would think it was evil. There are varying degrees of religious belief among us. For me, I could not in good conscience be a part of that. I have no interest or aptitude in the medical field, but as a notary, I would tell the person I personally cannot notarize that. Notaries make decisions about whether to take business all the time and for various reasons. It is wrong to criticize me here for referring to my conscience. I am sorry for whatever situation(s) each of you has or has had as to illnesses in the family. |
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middleVT
Afghanistan
38 Posts |
Posted - 04/06/2013 : 07:59:07 AM
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I think Anne McBride should check the terminology of her document. Titles such as "Living Will" or "Advanced Care Directive" tells a physician or other practitioner (physician's assistant, nurse practitioner, etc.) to consider the patient's wishes about care if the patient is unlikely to recover from his/her illness or injury. The physician might then issue appropriate orders, such as a DNR, referral to hospice, etc. On the other hand, the physician might decide the patient has a good chance of recovery and leave the default protocol in place, which is to take all measures to save the patient.
A DNR is not something that tells medical personnel to think about the patient's situation in light of the patient's wishes; that is supposed to already have happened. The DNR indicates the patient has already been diagnosed as having a short time to live and orders that life saving treatment such as CPR, defibrillation, or airway insertion not be performed.
An ambulance arrives to find a person very sick and in pain. The spouse hands the crew a DNR and the crew puts the person in the ambulance and starts toward the hospital, 30 minutes away. Five minutes into the ride, the patient stops breathing. The crew does nothing about it. They don't have a discussion about what the patient would want in this situation, or what kind of illness the patient has, or whether the stoppage in breathing is related to the underlying illness; the physician who signed the order already considered all that. They just continue to drive to the hospital. When they finally get there, the patient is dead and no medical treatment can do anything about it. That is how a DNR is supposed to work, so it shouldn't be issued to people who are not in the advanced stages of a terminal illness.
middleVT |
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amcbride
Maine
31 Posts |
Posted - 04/06/2013 : 06:53:06 AM
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I have a DNR. I wish everyone did. I'm a hospital Chaplain and these decisions should not be left to family. It is an emotional time for them. I believe leaving it creates unnecessary hardship and discontent amoung family members. The end of our life should be spent in comfort. I personally think that the lack of a DNR is selfish. No one should suffer to serve the egoistic selfishness of a family member.
We will all pass. "in God's time". Choosing to let a loved one suffer makes no sense.
Just my opinion.
Anne McBride |
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MsLisa
New York
18 Posts |
Posted - 04/05/2013 : 07:30:14 AM
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A DNR is the patients wishes and that should be respected. You cannot allow your personal feelings to get in the way of that.
My grandmother had a DNR and when she did pass, she did not have tubes and monitors hooked up to her. She didn't want that and we made sure her decision was respected.
If you are not comfortable in any situation, do yourself a favor and pass on the job at hand.
Lisa Cirillo |
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esnotary
California
125 Posts |
Posted - 04/04/2013 : 09:35:08 AM
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My ex-husband's father had a DNR order in place. He was 83 and not in good health. He told his children that if he had a heart attack he did not want CPR performed. I say, good for him! He later passed away in his own bed surrounded by family, instead of in a hospital with tubes and needles and all the "life-saving" discomforts. Where is the lack of concience in that? And as a non-partial third party, who cares anyway? Just do your job!
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LindaH
Florida
1754 Posts |
Posted - 04/04/2013 : 05:26:01 AM
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quote:
Originally posted by Sue
Every public official should have a conscience. Consider the alternative.
I'm sorry - I don't understand this statement.
Linda
http://www.columbiacountynotary.webs.com |
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Sue
Texas
22 Posts |
Posted - 04/03/2013 : 8:11:01 PM
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| Every public official should have a conscience. Consider the alternative. |
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middleVT
Afghanistan
38 Posts |
Posted - 04/03/2013 : 06:42:28 AM
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From Mistovich & Karren, Prehospital Emergency Care, 9th ed.:
"do not resuscitate (DNR) order a legal document, usually signed by the patient and his physician, that indicates to medical personnel which, if any, life-sustaining measures should be taken when the patient's heart and respiratory functions have ceased."
The original must be kept with the patient at all times and shown (by a friend, relative, or caregiver) to emergency medical personnel when they arrive, otherwise they will begin CPR regardless of any oral statements by anyone. I volunteer as an EMT. I have not yet been presented with one of these, but once when I had a teaching job one of my students had a congenital condition and a DNR.
My state does not have any particular format for a DNR; I have not heard that they need to be notarized.
middleVT |
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LindaH
Florida
1754 Posts |
Posted - 04/03/2013 : 06:16:31 AM
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Sue, why not?? It's a Health Care Directive, a Living Will, and it is the signer's wishes - it is the signer's direct instructions to their family on how they wish to be treated when they can no longer verbally communicate these wishes.
YOU are not responsible for the ramifications of signing that document.
You are a public official and an impartial third party - your personal beliefs should not infringe on that.
JMO
Linda
http://www.columbiacountynotary.webs.com |
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Sue
Texas
22 Posts |
Posted - 04/03/2013 : 05:53:58 AM
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| Do you mean "resuscitate"? I couldn't live with myself if I contributed to one of those. |
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jbelmont
California
3106 Posts |
Posted - 04/03/2013 : 03:12:37 AM
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Have you ever been asked to notarize a form that has instructions that say -- do not recessitate? Gulp. We have a notary in Northern California who has done one of these. He is going to write a really interesting blog article about that in a few weeks. Looking forward to that.
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Do not resuscitate? Notarized one of these?
