Fwd: PMDD and how HIPAA gives providers right to end patient's life

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<<< do you need a Protective Medical Decisions Document?

International Task Force

on Euthanasia and Assisted Suicide

Protective Medical Decisions Document

http://www.internationaltaskforce.org/pmdd.htm

What is the Protective Medical Decisions Document (PMDD)?

The PMDD is a protective Durable Power of Attorney for Health Care

which is available from the International Task Force. It is a

document in which you name someone you trust (a family member or a

close friend) to make health care decisions for you if you are ever

permanently or temporarily unable to make such decisions for yourself.

What makes a PMDD necessary?

The following are some of the reasons that a PMDD is necessary:

1. Federal regulations require every hospital and health program that

receives any Medicare or Medicaid funds to inform you, upon

admission, of your rights regarding an advance directive. As a

result, many facilities are giving patients a Living Will or Durable

Power of Attorney to sign at the time of admission -- when you're

naturally under stress and you're filling out other paperwork.

2. Many hospitals are instituting " futile care " guidelines which may

preclude the wishes of a patient who is unable to communicate. The

PMDD specifically states that the meanings of " beneficial "

and " appropriate " care are to be left to the agent who knows the

values and wishes of the signer.

3. An effort is underway across the country to add euthanasia and

assisted suicide to end of life options. The PMDD specifically

prohibits euthanasia and assisted suicide.

4. Previously, family members were automatically considered the

decision makers for a loved one. This is rapidly changing. Unless you

have named someone as your agent to make decisions for you if you

can't give informed consent, a health care provider or court

appointed guardian who doesn't know your values and wishes may make

critical decisions for you.

5. Ever since the federal Health Insurance Portability and

Accountability Act (HIPAA) went into effect, some health care

facilities have refused to provide information to anyone - even

family members - about a hospitalized adult unless the patient has

given written consent. The PMDD gives your agent the authority to

obtain necessary information in the event that you are unable to give

written consent at the time of hospitalization.

Taking the time now to sign a PMDD will assure you that you have

carefully chosen the family member or friend who will protect your

best interests if you can't speak for yourself.

Who should have a PMDD?

It's a good idea for every person who is 18 years old or older to

have a PMDD. Many people assume that such a document is only

necessary for the elderly or for the seriously ill, but people of any

age or health condition could be in an accident after which they

could be temporarily or permanently unable to make their own health

care decisions.

How does the PMDD differ from a " Living Will " ?

The PMDD is a Durable Power of Attorney for Health Care. A Living

Will is a document, often called a " declaration " or a " directive, " in

which the signer gives power and authority to an " attending

physician " to withhold or withdraw medical interventions under

certain circumstances. Because the " attending physician " may be a

total stranger who is completely unfamiliar with the signer's values

and wishes, terms in the document may be interpreted by the physician

in a manner that was not intended by the signer. Also, with the

Living Will, family members and others -- who are familiar with the

signer's values and wishes -- have no legal standing to interpret the

meaning of the directive.

Are there any limitations on my agent's authority?

Yes, the PMDD limits your agent's authority in one specific way. It

makes it clear that your agent does not have the authority to approve

the direct and intentional ending of your life.

For example, your agent may not authorize that you be given a lethal

injection or an intentional lethal drug overdose. Further, your agent

may not direct that you be denied food or fluids for the purpose of

causing your death by starvation or dehydration.

This limitation not only protects you but also protects your agent

from being subjected to pressure to authorize such actions or

omissions.

If I'd like to give my agent other directions or express other

special provisions, should I add these in writing to my PMDD?

Although you may legally add other provisions in writing, you are

advised not to do so.

The " Statement of Special Provisions, Directions and Limitations "

found in the PMDD lists those areas where specific language is

necessary in the current medical climate.

For example, some health providers have taken it upon themselves to

put DNR orders in place without the patient's or agent's

authorization. Similarly, some health providers, ethics committees

and health facilities are deciding what is " appropriate "

or " beneficial " based on quality-of-life decisions that may be at

variance with a patient's values. Thus, the PMDD makes it clear that

DNR orders and decisions about what is " appropriate " or " beneficial "

are made only by the agent (if the PMDD signer is not able to do so).

Since it is not possible to predict all circumstances that may be

faced in the future and it is not feasible to cover all possible

interventions, adding specific written directions may severely limit

the discretion and flexibility that your agent needs and may restrict

your agent's authority in a way you didn't intend. In addition, if

you add specific written directions you won't be able to alter them

through discussions between you and your agent. You would have to

execute an entirely new document.

Instead of including any additional provisions or directions in

writing, discuss them in detail with your agent both when you sign

your PMDD and after periodic review of your document.

Who may serve as my agent?

It is important to select your agent carefully. Although an agent is

also called an attorney-in-fact, that person need not be an attorney.

You may wish to select a spouse, other family member or close friend

as your agent. Your agent should be an adult who shares your values

and whom you trust to make decisions on your behalf. He/she also

should be a person who will be comfortable asserting your rights.

Do I need more than one agent?

You are not required to name more than one agent but it is a good

idea to name one or two alternates so that, if your agent is not

available or is incapacitated, an alternate may act on your behalf.

Alternates should be selected with the same degree of care as your

primary agent.

How many sets of PMDD documents should I sign?

You should give a completed, witnessed and signed PMDD to your agent

and to your alternate agent(s) since they would need it to prove that

they have the authority to make decisions for you.

You may also wish to make photocopies of the signed, witnessed

document for your own records and for a friend, neighbor or health

care provider so that they could easily contact your agent in the

event of an emergency.

(Do not keep your PMDD in a safe deposit box or any other place that

is inaccessible.)

Why does the PMDD specify that photocopies of my signed document

aren't considered valid?

Your PMDD limits the use of photocopies to use for informational

purposes only. By requiring valid documents to have original

signatures, you are protected if you decide to revoke your PMDD or

designate someone else to be your agent. You need only retrieve and

destroy those few signed documents. On the other hand, if photocopies

of your signature were valid, you would have no way of knowing how

many photocopies were made by others or to whom they were given.

Is the PMDD valid in every state?

The Multi-State version of the PMDD conforms with the laws of most

states. Some states, however, have specific statutory requirements

for a durable power of attorney for health care. For those states,

the ITF distributes PMDDs specifically drafted to meet the state's

technical requirements. Those states include: AK, AL, CA, CT, DE, FL,

HI, IN, MI, MN, MO, NC, ND, NE, NH, NV, OH, OK, OR, SC, TN, TX, UT,

VT, WV and WI.

If I have signed a PMDD in one state and move to a state that has

different statutory requirements, do I need to sign a new PMDD? No.

If your PMDD was valid in the state where you signed it, it will be

honored in another state.

How can I get a PMDD?

PMDD packets are available from the ITF. Each packet contains a

question and answer sheet, a checklist. three PMDD documents and a

Protective Identification Card.

You can write (see address below) or phone (see phone number below)

the ITF and request a packet, or you may print out and fax a signed

copy of the ITF order form.

found at:

http://www.internationaltaskforce.org/order_form.htm

Be sure to designate which version of the PMDD (Multi-state or AK,

AL, CA, CT, DE, FL, HI, IN, MI, MN, MO, NC, ND, NE, NH, NV, OH, OK,

OR, SC, TN, TX, UT, VT, WV or WI) you want. A donation of $8 is

requested for each PMDD packet.

Print Order Form,

Make checks payable to " The International Task Force " and mail to:

International Task Force

P.O. Box 760

Steubenville, OH 43952

phone orders

800-958-5678

(9:00 a.m. - 4:00 p.m.)

(Eastern) (Weekdays)

(credit card orders only)

Make checks payable to " The International Task Force " and mail to:

International Task Force; P.O. Box 760; Steubenville, OH 43952 USA >>>