Making Your Wishes Known
The second consideration with an Advance Directive gives you two choices that address whether or not you would want aggressive or heroic treatment if you were suffering from a terminal condition, vegetative state, or a condition that would result in an undesirable quality of life. On your Advanced Directive form, you may check one of these boxes and/or you may also write more specific wishes regarding what you would or would not want a healthcare team to do. You are encouraged to discuss any questions or concerns about treatment with your physician.
You may be as specific as you would like regarding the type of treatment and situation. Different treatments you might consider are cardiopulmonary resuscitation (chest compressions), defibrillation (electric shock to the heart with paddles), being placed on a ventilator (breathing machine), surgery, pain management and feedings through a tube. The situations you might want to consider are those in which you have suffered irreversible injury to the brain and/or body, such that your previous quality of life is not likely to return. This could be due to head trauma, stroke, terminal illnesses or the failure of your organs. If you do not have enough room to write, you may add a piece of paper, which you should sign and date at the end.
Donation of Organs/Tissues at Death
It will be helpful to your loved ones and the healthcare team if you complete this section. You can designate any usable organs and tissues to help another person through transplantation, for research or for both. Note: If your organs and tissues cannot be used for transplantation, they will be designated for research unless you state otherwise.
Remember to sign and date your advance directive.
On the final page, you must have your signature witnessed or notarized. If you wish to have your signature witnessed, choose two people who are 1) present when you sign it; 2) not mentioned in the document; 3) not employees of the facility in which you live; and 4) not Huntington Hospital staff, volunteers or physicians. One of the witnesses must not be related to you in any way or be named in your Will, and must sign a statement that says such.
If finding appropriate witnesses is inconvenient or difficult, the hospital can refer you to a Notary while you are here, or you may locate one in the community through the phone book. Notaries charge a fee for their service.
If you reside in a skilled nursing facility, their Ombudsman must witness your signature on your Advance Directive form.
Print out the following introduction
Information provided by Coalition for Compassionate Care of California (CCCC).