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
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).
Things to Consider
Select the number (on a scale of 1 - 3) that best describes your situation for each item or issue. You can total your scores if you wish to get a big picture of the situation. Lower scores indicate less manageable situations -- situations requiring additional support beyond the primary caregiver -- and higher scores indicate situations that may be more readily managed.
The care receiver is usually:
_____ (1) Confined to the bed
_____ (2) Homebound, but not bed bound
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.
The ability to understand the nature and consequences of health care
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
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.
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