Paramedics are often called to a home because of an emergency situation, and most people desire that extraordinary medical procedures be utilized in a time of crises. But this is not the case in every situation.
While an individual is competent, he or she may exercise their opinion to have treatment provided to them or discontinued, so that no further attempt should be made to provide them with life support and related medical treatment. While competent, it is relatively straight forward and easy for someone to make decisions regarding their own health care. When competency falls into somewhat of a gray area, the test for competency helps to determine whether the patient understands the nature of their illness and the effects that proposed treatment or lack thereof would have on them.
In Massachusetts a Health Care Proxy designates another person to substitute for the patient in making decisions regarding end of life and ongoing healthcare treatment.
However, the standard form provided by medical facilities does not provide for a so-called Do Not Resuscitate Order (DNR.) Many individually prepared documents do include language that permits the agent under the Health Proxy to make decisions for the patient relative to all medical decisions, including end of life and possibly a DNR.
In the absence of a Health Care Proxy, a guardian will have to be appointed by the Probate Court in order to not only determine ongoing care for the patient, but also for extraordinary treatment or the withdrawal of that treatment.
This process will likely be even more drawn out as a result of the enactment of the Uniform Probate Code of 2009, which protects an incapacitated person’s rights by instituting various protections or hurdles that must be overcome before a decision is made regarding incapacitated person’s health care, especially end of life decisions.
All of these issues may be more compounded when there is a contest regarding who should serve as the Guardian and whether or not the person’s end of life decisions are being carried out in a manner that is appropriate for them and as they may have desired.
A DNR Order becomes a separate and distinct issue relative to the decision making process, as it normally is executed by a person and is also signed off as accepted by that individual’s physician.
Normally, when paramedics are called to a home, they must take all action necessary to preserve the life of the patient, but they are protected from potential liability by a DNR Order, which allows them to withhold life sustaining measures.
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