• Advance Directive

    Prepare Now For a Possible Medical Emergency! Perhaps no one in recent memory has gained so much notoriety because of a lack of something than Terri Schiavo. What did she lack?
    Prepare Now For a Possible Medical Emergency! Perhaps no one in recent memory has gained so much notoriety because of a lack of something than Terri Schiavo. What did she lack? Something that many people also do not have. She never prepared an Advance Directive stating her wishes concerning how she wanted to be treated medically in the event that she could not speak for herself. Had she done so, the fifteen-year-long, agonizing, life and death controversy that roused the American public, its lawyers, doctors, and politicians to heated debate, would most likely have been averted. Her story has much to teach the rest of us. Do you have an Advance Directive ? Have you prepared a Durable Power of Attorney for Healthcare or a Living Will? Do you know what legal purposes these documents serve, and why you should have them? In today’s complex and legalistic health care system, it is vital that every adult prepare and carry one or preferably both of these documents in case of a medical emergency. Make your health care team — and everyone else involved — smile. Let us help you get yours done today.

    NoBlood User Survey (January 2006)

    Have you executed an up-to-date Advance Directive and/or Medical Power of Attorney (MPA)?


    In January of 2006, we conducted an anonymous survey of NoBlood users. One of the questions we raised was, “Have you executed an up-to-date Advance Directive and/or Medical Power of Attorney (MPA)?”. Of the 620 who were willing to answer that question, about 30% admitted to not having executed their Advance Directive. What is most interesting about this statistic is that these were registered users of NoBlood who had demonstrated a clear interest in bloodless healthcare.
    If you have not completed a MPA, is it because: (check all that apply)


    We presented a complimentary question that was even more interesting, “If you have not completed a MPA, is it because: (check all that apply)”. Of those who had not executed their Advance Directive, 46% responded, “I have not fully researched the issues”. If this is the reason why you have not executed your Advance Directive, we hope that NoBlood will be a helpful resource in this regard.

    Nomenclature

    There are various acronyms used around the world that refer to Advance Directive forms. The following are some of these. Are we missing any? If so, Get Involved !

    • Medical Power of Attorney (MPA)
    • Durable Power of Attorney for Healthcare (DPA for Healthcare)
    • Health Care Directive (Living Will)
    • Physician Orders for Life-Sustaining Treatment

    Resources for Healthcare Directives and/or Power of Attorney

    Some organizations, such as Jehovah's Witnesses, provide forms for baptized members and their minor children. Others may obtain these from:


    Express your wishes

    Obviously, it is preferred that you include all of your wishes in one main document. However, you might not have enough room on a preprinted form to be as specific as you would like. Rather than trying to squeeze handwritten instructions into a few small lines, risking illegibility, you may create an addendum to the Advance Directive. Most forms provide a small space to qualify your wishes or add other items. In that space, write or type "See attached Addendum to Medical Durable Power of Attorney dated [fill in the date the Advance Directive was signed], which is fully incorporated herein by this reference." Then prepare a separate page (preferably typewritten) entitled "Addendum to Medical Durable Power of Attorney dated [use Advance Directive date]. Clearly set forth your specific wishes, and make sure at the bottom of the page there is a signature line and places where anyone who is required to witness your signature can sign or initial below your own signature. The following are examples of expressions that may be used, on your own Advance Directive, to express your wishes in the most concise way possible.

    • Section 5(c) - With respect to minor blood fractions or products containing minor blood fractions, according to my conscience, I ACCEPT SOME , as follows:
      • Products that may have been either processed with, or contain, minute amounts of albumin (e.g., streptokinase and some recombinant products such as erythropoeitin (EPO) and synthesized clotting factors; and some radionucleotide scan preparations that may contain very small amounts of albumin).
      • Immunoglobulins (e.g., Rh immune globulin, gammaglobulin, snake bite antivenin, and others either processed with, or containing, minute amounts of plasma fractions or albumin).



    • I ACCEPT ALL minor fractions of blood WITH THE EXCEPTION OF :
      • those that are given as volume expanders.
      • cryoprecitate, if re-suspended in plasma.
      • hemoglobin-based oxygen carriers.

    • I ACCEPT ALL medical procedures involving the use of my blood during the course of a surgical procedure WITH THE EXCEPTION OF :
      • when blood, leaving my body to be re-infused, is not maintained in a closed circuit.
      • when some of my blood, being drawn for tagging purposes, actually leaves the room.
      • plasmapheresis, if plasma is used as the replacement fluid.


    PLEASE NOTE: The above are intended to serve only as examples; as you adapt your own document to suite your individual needs.

    Advance Directive Nuances by Location

    It is important, when preparing and executing your Advance Directive, to be aware of potential 'nuances' that may apply in your area. We are compiling some examples here so, please, feel free to add any that are missing. Get Involved !

    Australia

    Canada

    New Zealand

    Called a Health Care Directive , it differs in the following ways:
    3. Regarding minor fractions of blood: [Initial those that apply]
    (a) I REFUSE ALL
    (b) I REFUSE ALL EXCEPT: _____________________
    (c) I may be willing to accept some minor blood fractions, but the details will have to be discussed with me if I am conscious.
    4. Regarding medical procedures involving the use of my own blood , except diagnostic procedures, such as blood samples, for testing: [Initial those that apply]
    (a) I REFUSE ALL
    (b) I REFUSE ALL EXCEPT: ____________________
    (c) I may be willing to accept certain medical procedures involving my blood, but the details will have to be discussed with me if I am conscious.
    11. STATEMENT OF WITNESSES: The person who signed this document did so in my presence. He or she appears to be of sound mind and free from duress, fraud or undue influence. I am 20 years of age or older, and I am not related to the person who signed this document, by blood, marriage or adoption.

    UK

    USA

    • We are on the border of Washington and Oregon States and an FAQ is, "If I come from Oregon to Washington for health care, do I need a directive for both states"?
      • Answer: If you fill out your directive for the state you live in, it is still honored. If you move, then you need to fill out a new directive for that state.



    • There are minor differences among different states. Washington State requires two people to witness your signature and they cannot be related by blood or marriage; however, in Oregon, one witness can be related, but cannot be your healthcare agent. It is a good idea to be mindful of the requirements for the state you reside in.

    Samples

    The following are links to sample Advance Directives. They are intended to serve as examples; as you adapt your own document to suite your personal needs. As with any legal document intended to represent you in the event that you can not, you are strongly urged to consult with appropriate legal and/or health care professionals.

    USA

    California


    See also

    • Our Kingdom Ministry 2004 December p. 7 New Provision to Assist Us to Abstain From Blood
    • Awake 1991 March 8 pp. 4-5 Hospitals—When You Are a Patient

    Related Articles

    Pediatric Court Orders | Erythropoietin (EPO) | Acute Normovolemic Hemodilution (ANH) | Epidural Blood Patch (EBP) | Patients_Who_Refuse_Blood_Transfusions_-_FAQs | Intraoperative blood salvage | Blood Fractions Guide
    Comments 1 Comment
    1. LarryEitel's Avatar
      LarryEitel -
      Now that we have moved articles that previously resided in a 'wiki' to our newly upgraded site, I would like to invite anyone interested in how to improve materials on this site related to how to more intelligently prepare an Advance Health Care Directive. I have updated some of the links in this article which point to a few sample versions. I based my Advance Directive on one of these templates since I needed more space to express my wishes.
      There is an opportunity to organize materials to assist anyone seeking further information to determine how to best their own Advance Directive. Interested? Please let me know by clicking the Contact Us at the bottom of this page. Thank you
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