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End of Life Information

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End of Life Information

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Today, advances in medicine and medical technology save many lives that only 60 years ago might have been lost. Unfortunately, sometimes this same technology also artificially prolongs life for people who have no reasonable hope of recovery.

No one likes to think about death and dying, but they are inescapable realities of life. Armed with the information and forms in this packet, you can take control of choices regarding your medical future.

In 1991 Ohio recognized your right to have a Living Will. This was in addition to Ohio's other recognized advance directive at that time, the Health Care Power of Attorney. In 1998, Ohio recognized yet another tool to help you and your physician do effective health care planning called a DNR (Do-Not-Resuscitate) Comfort Care or Comfort Care Arrest Order. All of these measures help put control over future medical choices in your hands.

The Living Will allows you to decide and document, in advance, the type of care you would like to receive if you were to become permanently unconscious or terminally ill and unable to communicate. The Health Care Power of Attorney enables you to select someone to make decisions for you.

A person who does not wish to have Cardiopulmonary Resuscitation (CPR) performed may make this wish known through a doctor's order called a DNR Order. A DNR Order addresses the various methods used to revive people whose hearts have stopped functioning (cardiac arrest) or people who have stopped breathing (respiratory arrest). In 1998 a DNR Law was established to help people communicate their wishes about resuscitation to medical personnel inside or outside a hospital or nursing home setting. It allows emergency medical workers to honor a person's physician-written DNR Order in the home, nursing home or various other settings. The 1998 DNR Law also protects emergency squads and other health care providers from liability if they follow a person's DNR Order.

Following the establishment of the 1998 DNR Law, the Ohio Department of Health established two DNR Comfort Care orders which allow people to choose the extent of the treatment they wish to receive at the end of life. A person with a "DNR Comfort Care Arrest Order" will receive all the appropriate medical treatment until the person has a cardiac or respiratory arrest, at which point only comfort care will be provided. By requesting the broader "DNR Comfort Care Order," a person is choosing to have only comfort care measures provided should an event occur that is life threatening or ending. Your physician or health care provider can explain the differences in DNR Orders.

In addition to the Living Will and Health Care Power of Attorney forms, you will find a copy of the Donor Registry Enrollment Form in this packet. This card should be used to register your intent to be an organ donor upon your death. Also included in this packet is information about DNR Orders and about hospice choice, which offers further information about end-of-life issues and options.

It is important to understand what Ohio's laws do or do not do in regards to expressing your desires, goals and wishes by using tools such as Ohio's Advance Directives. This packet is meant to educate you about Ohio's Living Will; Health Care Power of Attorney; Organ, Tissue and Eye Donation; and the new 1998 DNR Law. The goal is to provide you with the information you need to document your future health care decisions. The information and forms in this packet are made available to you through the collaborative effort of the Ohio Hospice & Palliative Care Organization, the Ohio State Medical Association, the Ohio Hospital Association and the Ohio Osteopathic Association. The Ohio State Bar Association prepared the Living Will and Health Care Power of Attorney forms.

After reviewing the contents of this packet, you might have additional questions or concerns specific to your personal situation. In such a case, it is important that you discuss your concerns with your family, your physician and your lawyer.

If you choose, you can fill out the Living Will or Health Care Power of Attorney forms by yourself; you are not required to use a lawyer. However, since these are important legal documents, you might wish to consult a lawyer for advice.

In contrast, a DNR Order cannot be completed without the help and skill of a physician. A physician, certified nurse practitioner or clinical nurse specialist, as appropriate, must complete a DNR Order. If you would like to indicate that you do not wish to have cardiopulmonary resuscitation, you will need to have a discussion with your physician. Your physician can explain the differences between DNR Orders and their application.

The issues involved in drafting or determining one's wishes regarding a DNR Order, Living Will, Health Care Power of Attorney or being an Organ Donor are very important. We hope this information and these materials are useful in helping you to make a decision that is comfortable for you and your family.

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