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Advance directives

Individuals have the right to make decisions concerning their care, including the right to accept or refuse medical or surgical treatment, and the right to formulate advance directives as permitted under state statutory and case law.

No individual shall be discriminated against or have care conditioned upon whether the individual has executed any advance directives.

The individual has the right under state law to make decisions concerning medical care, including the right to accept or refuse medical or surgical treatment, and the right to formulate advance directives upon request.

If the patient chooses to execute an advance directive, written information shall be provided upon the individual's request by case management/social services or a hospital designee.

Hospital's policy

At the time of admission or before discharge, the patient rights to execute advance directives will be provided to each hospital inpatient or daybed patient over the age of 18.

The hospital has the right to withhold the distribution of information to certain inpatients who are not in a condition to accept written information.

Copies of advance directives will be transferred with the individual upon transfer to any other health care facility.

Advance directive

The patient or patient's representative shall be responsible for providing the hospital with a copy of the patient's advance directive, living will, durable power of attorney or other written documentation that expresses the individual's health care treatment decisions.

Copies shall be made a permanent part of the individual's medical record when provided to the hospital.

This includes:

  • A living will.
  • A durable power of attorney for health care.
  • Any other written document executed by the individual, signed and dated, that expresses the individual's health care treatment decisions.

If the individual has an advance directive from a state other than Missouri, the hospital attorney may be notified to determine its effect.

If the individual has capacity—which is defined as being able to receive and evaluate information regarding the treatment issue and to communicate, either verbally or nonverbally, a decision—the individual may orally state any advance directives in the presence of any two witnesses. These may include the attending physician and other hospital personnel. Any oral advance directive shall be documented in the individual's medical record by the physician or nursing personnel to whom the advance directives were given.

Readmissions: Any oral advance directive shall be effective only during the current admission. Copies only need to be provided if one is not already scanned into medical records. Any advanced directives on file need to be acknowledged, verified and updated as needed.

Notification of physician

Written notification will be provided to the individual's attending physician and will be placed on the individual's chart to alert all who are providing care.

Any staff physician who is unwilling to comply with an individual's advance directive shall not interfere with the patient's transfer to another physician.

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