Health Care Proxy and Advanced Medical Directives

The New York Health Care Proxy Law allows you to appoint someone you trust - for example, a family member or close friend - to make health care decisions for you if you lose the ability to make decisions yourself. By appointing a health care agent, you can make sure that health care providers follow your wishes.

Your agent can also decide how your wishes apply as your medical condition changes. Hospitals, doctors and other health care providers must follow your agent's decisions as if they were your own. You may give the person you select as your health care agent as little or as much authority as you want. You may allow your agent to make all health care decisions or only certain ones. You may also give your agent instructions that he or she has to follow. You can also use the Health Care Proxy (or your New York State Driver's License) to document your wishes or instructions with regard to organ and/or tissue donation.

A living will directs your agent as to your end-of-life choices, which may include instructions to your health care provider to withdraw life support if you are terminally ill or in a vegetative state. Other advanced medical directives may include instructions not to resuscitate if your heart stops, not to intubate if you need assistance breathing or other anticipated directives. Also in our region of New York a Medical Orders for Life Sustaining Treatment ("MOLST") is very common in geriatric cases. Honoring patient preferences is a critical element in providing quality end-of-life care. To enable physicians and other health care providers to discuss and convey a patient's wishes regarding cardiopulmonary resuscitation (CPR) and life-sustaining treatment, the New York State Department of Health has approved a physician order form, the MOLST, that can be used statewide by health care providers and facilities as the legal equivalent of an inpatient Do Not Resuscitate (DNR) form.

MOLST was created by the Community-wide End of Life Palliative Care Initiative to provide a single document that would function as an actionable medical order and could transition with a patient through all health care settings. It is intended that the form will be transported with the patient between different health care settings in order that their wishes for life-sustaining treatment and CPR will be clearly indicated. For additional questions, visit their web site at http://www.compassionandsupport.org