Health Care Agents - Appointing One and Being One

Glossary

Advance Directive
A general term that describes two kinds of legal documents, living wills and medical powers of attorney. These documents allow you to giveinstructions about future medical care and appoint a person to make health care decisions if you are unable to make them yourself. Each state regulates the use of advance directives differently.

Benefits and Burdens
A commonly used guideline for deciding whether or not to begin or stop medical treatments. A benefit can refer to the successful outcome of a medical procedure or treatment. Outcomes can be medical (e.g. the heart beats again) or functional (e.g. the person is able to walk to the bathroom after being incapacitated by a stroke), or one that supports the patient's values (e.g. the patient is able to die at home as wished).

However, a benefit from one point of view can be experienced as a burden from another and might be viewed differently by doctors, patients and families. For example, if a patient's heart stops, is resuscitated, and the heart starts beating again, this is a successful outcome from a medical point of view and a doctor may consider it a benefit. To the patient who is dying from a serious illness or disease, resuscitation may cause further injury and only contribute to the overall experience of suffering. This success, from the doctor's point of view, might actually be experienced as an additional burden by the patient. Discussions of the benefits and burdens of medical treatments should occur within the framework of the patient's overall condition and goals for care.

Capacity
The ability to understand the nature and consequences of health care decisions.

Cardiac Arrest
An event in which the heart stops beating, causing all body functions to shut down, including breathing.

Cardiopulmonary Resuscitation (CPR)
CPR is the medical treatment used by health care providers to restart the heart and/or restore the breathing of someone who suffers a cardiac or respiratory arrest. CPR involves a group of procedures that may include artificial respiration and intubation to support or restore breathing, and chest compression or the use of electric stimulation or medication to support or restore heart function.

Do-Not-Intubate (DNI) order
A physician's written instructions to health care providers not to intubate (see "intubation" below) a patient who is experiencing breathing difficulties.

Do-Not-Resuscitate (DNR) order
A physician's written instructions to health care providers not to perform CPR if a person experiences cardiac or respiratory arrest.

Emergency Medical Services (EMS)
A group of governmental and private agencies that provide emergency care, usually to people outside of health care facilities; EMS personnel generally include paramedics, first responders and other ambulance crews.

Healthcare Agent
The person named in an advance directive or as permitted under state law to make health care decisions on behalf a person who is no longer able to make medical decisions.