Many people today are concerned about the medical care they would be given if they should become terminally ill or unable to communicate their health care choices. They don’t want to spend months or years dependent on life support machines, and they don’t want to cause unnecessary emotional or financial distress for their loved ones.

That is why a growing number of people are taking action before they become seriously ill. They are stating their health care preference in writing while they are still healthy and able to make such decision, through legal documents called Advance Directives.

1. PeaceHealth Oregon Region is required by Federal and State law to ask each admitted patient or others as designated (18 years of age or over), if they have an Advance Directive.

2. Effective November 4, 1993, the Oregon Legislature revised Oregon’s Advance Directive laws. Two major changes were made: First it merges the current power of attorney for health care and directive to physicians forms into one unified form, and second, it outlines the requirements for withholding or withdrawing life sustaining procedures in certain circumstances.

3. An Advance Directive states your medical treatment wishes, should you be unable to speak for yourself.

4. An Advance Directive can be:
   1. Appointment of a Health Care Representative
   2. Health Care Instructions

   3. Both

5. Enclosed are copies of the Appointment of a Health Care Representative (Part B) and Oregon Health Care Instructions (Part C).

6. It is the intent of PeaceHealth Oregon Region and its representatives to comply to the best of their ability with a competent adult’s, or their representative’s, right to accept or refuse medical/surgical treatment, or a physician’s order for the withholding of life-saving procedures in accordance with hospital policy, Oregon Advance Directives, and Oregon law.

7. Hospitals are also required by Oregon law to request organ or tissue donation when a patient dies. A hospital representative will make this request of a family member or relative, when appropriate. You can express your desire for anatomical donation at any time by completing a Uniform Donor Card and completing the Anatomical Gift form in this packet which can direct retrieval of tissues following death.

Can my representative prevent or stop life support? Yes, if your Advance Directive form says so. If you have not given specific instructions, the law specifies four critical medical conditions in which your representative may decide about life support for you:

• Life support would not benefit you and would cause you permanent and severe pain;
• You are close to death and life support would only postpone the moment of your death;
• You are permanently unconscious; or

• You are in an advanced stage of a progressive, fatal illness.

The law also allows your representative to decide about life support in other circumstances you designate on the form. But you must get routine care for your cleanliness and comfort. Life support will not be prevented or stopped if your form says you would want it continued.

Can my representative prevent or stop food and water by tube? Yes, if your Advance Directive form says so. In addition, your representative may prevent or stop tube feeding if you have clearly said that you would refuse it. Otherwise, you must get tube feeding that would prolong your life, unless you have one of the four critical medical conditions that the law specifies. Your representative cannot refuse food or water you can take in a normal way.

How are decisions made for me if I do not have an official form? If you have one of the four critical medical conditions that the law specifies, an Oregon statute allows close relatives and friends to decide about life support for you. Otherwise the law does not clearly identify the decisions that relatives or friends may make for you. Relatives, friends, or others may seek clear authority from a court by being appointed your guardian.

Is an Advance Directive I signed under another state’s law good in Oregon? Yes, if you did not live in Oregon when you signed it. Oregon residents may only use an Oregon form.

Are Oregon’s earlier official forms still good? Yes, if you signed a Power of Attorney for Health Care or a Directive to Physicians before November 4, 1993, you can still use it. Even though the old forms are similar to the Advance directive, there are some big differences:

• A Directive to Physicians is a legal statement that you do NOT want artificial life support which would only postpone your death when you are terminally ill.
• A Power of Attorney for Health Care allows your representative to stop life support if you checked the line on the form referring to “life-sustaining procedures”. It allows your representative to prevent or stop food and water by tube if you checked the line on the form referring to “artificially administered nutrition and hydration”. Otherwise, the form allows your representative to forego tube feeding for you only if you have one of the four critical medical conditions that the law specifies.

• Unless you sign an Advance Directive, the Directive to Physicians remains in effect unless or until you revoke it. The Power of Attorney for Health Care expires after seven years unless you are already incapable when it expires.

Physician Assisted Suicide: It is the policy of Sacred Heart Health System that its facilities, staff and volunteers while representing Sacred Heart Health System shall not be involved in physician assisted suicide. Your physician or the hospital’s Pastoral Care department can provide you with additional information on this policy.

1993, Oregon State Bar Health Law Section. The Section hereby authorizes anyone to reprint this statement, as long as it is reprinted in its entirety (including this paragraph) and without any change in wording.