Life Support Decisions

You have the right to participate in your treatment plan during hospitalization. One of your most important rights is to make informed life support decisions.

Life support decisions differ from an advance directive, which you may already have. An advance directive is only used if you are unable to tell your physician your treatment plan choices. Life support choices are ones you make with your physician and family while you still can.

What do you mean by "choices?"

The decision to have—or not have—specific treatments or procedures. There are a broad range of choices that can be made, from "everything" being done to preserve life, to rejecting all medical treatments entirely.

What specific treatments or procedures are emergency life support options for me?

Treatment choices vary depending on the situation. You may be asked to make choices for an emergency situation or for ongoing life sustaining care. A separate card outlining the five categories of "Level of Intensity of Care" (LOI) is available from your nurse, social worker or the patient representative.

Can I change my mind once a decision is made?

Yes, you always have the option and do not be afraid to speak up. It is your right to discuss your treatment choices with your physician. In fact, many people do have a "change of heart."

For example: You have always told your family physician "I never want one of those breathing tubes," but during hospitalization you start to develop difficulty breathing and realize you may want a breathing tube. Immediately tell your nurse or physician of your decision.

Medically, your condition may change and you may be faced with end of life decisions. After you and your physician have fully discussed these choices, the decision will be recorded in your chart. Please understand that you have the right to a complete and thorough explanation of these choices.

You also have the option to change your decision if you and your family feel it is necessary. We know that these are private and personal decisions, and we respect that privilege. Our staff is always available to answer your questions, support your decision and act as your patient advocate.

For additional information, please ask for the handout on "Level of Intensity of Care" from your nurse, social worker or patient representative. If you need more information on life support decisions, talk with your physician, nurse or social worker.

Important Terms

There are several terms that you may need to understand as you prepare an advance directive or make life support decisions. The definitions below should help you understand some of the forms of medical treatment for which you may be making choices.

Artificial Hydration (fluids)
Salt or sugar fluids given into a vein for someone who cannot drink.

Artificial Nutrition (feedings)
Liquid food given through a tube into the stomach or into a vein.

Brain Death
Complete stopping of all function of the brain that cannot be reversed. A brain-dead person is not in a coma, but is, in fact, dead.

Cardiopulmonary Resuscitation (CPR)
Chest massage and mouth-to-mouth breathing done to try and revive a person when the heartbeat and breathing stop.

Defibrillation or Cardioversion
Electrical shock to the heart to return it to a normal heartbeat.

Endotracheal or "Breathing" Tube
A tube placed in the lungs which can be attached to a ventilator.

Kidney Dialysis
A machine connected to your body for a number of hours at a time. It does the work of the kidneys when they cannot work on their own.

Incompetence
The lack of sufficient capacity for a person to make or communicate decisions concerning himself.

Level of Intensity (LOI)
Treatment choices vary depending on the situation. There are five levels, or categories of intensity, based on each situation ranging from doing everything to nothing in order to save a person's life.

Medications
IV (intravenous) drugs used to help the blood pressure or restore a regular heartbeat; or antibiotics for infection.

Organ/Tissue Donation
A life-saving procedure by which vital organs such as kidneys, livers, hearts, lungs and the pancreas are surgically recovered from one individual and transplanted into another. Some tissues that can be donated include bone, skin, corneas, blood vessels and heart valves.

Permanently Unconscious
A condition in which a patient is determined to be in a state of total loss of consciousness which cannot be reversed.

Surrogate
The appointment of another person to act on your behalf.

Ventilator (respirator or "breathing machine")
A machine that breathes for you or helps you breathe.