Hospitals are required, by federal law, to provide all adult patients with information on:
- Their rights under state law to make decisions in regard to their medical care
- Their right to make an “advance directive” and
- The hospital’s policies regarding such rights
This material has been prepared to provide you with this information. We hope it is helpful to you. Please talk to your physicians, nurses or other providers at the hospital if you have any questions.
Translators are available for assistance in reviewing this information. If you would like more information on translations, and are calling from outside the hospital, please call 617.636.5547. If you are calling from within the hospital, please call 6-5547.
There may come a time when you are seriously injured or become gravely ill, and are unable to make decisions about your own medical care. Your family, friends, and caregivers may have to make decisions on your behalf about the nature and intensity of the medical care you receive, including decisions about whether or not you are kept alive on life-support systems.
While advances in medical technology have saved many lives, sometimes these treatments are futile, or sometimes the burdens of the treatment outweigh the benefits. You may have your own views as to what treatment you want if you become unable to make decisions on your own behalf. Your family and others may not be aware of these wishes. Without knowing what you would want, your family and others may find it hard to make decisions for you.
Giving advance instructions
You can help ensure that your wishes are followed, and help those who will have to make decisions on your behalf, by taking steps now. In Massachusetts, the law specifically provides for naming someone (for example, someone who is close to you, such as a spouse or close friend) to serve as your “health care agent” and make medical decisions for you if you become unable to make these decisions yourself.
A health care agent is appointed by means of a health care proxy. (A proxy form is included.) You can also, if you wish, include in the proxy specific instructions about what medical care you want—or do not want.
However, setting limits on your health care agent’s authority might make it difficult for your agent to act for you in a situation that you have not anticipated. Therefore, rather than including specific instructions in the proxy, you may want to provide your agent with flexible guidelines, either through discussions with your agent or by means of a separate document clearly labeled “Guidelines Only.”
Discussing the issues
Because it is difficult to anticipate what kind of medical care you might want in the event of a future illness, you are encouraged to discuss the medical issues with your physician before preparing your health care proxy. You are also encouraged to talk to your health care agent about your values and what kind of medical care you might want—or not want—in certain circumstances.
For example, you might want to discuss with your doctor and your health care agent the circumstances under which you would want to be revived if your heart and breathing stop, and when you would want various forms of life-support (such as breathing tubes and machines, and feeding tubes). You should also consider discussing the kind, and intensity, of treatment you would want if you become unconscious and are not expected to recover. Among the forms of treatment that may be offered to you in various circumstances are: respirators, artificial nutrition and hydration, and kidney dialysis.
You might also want to discuss with your physician and agent how important certain things are to you such as:
- Having the ability to communicate with family and friends
- Having your life prolonged, even if machines are necessary
- Following the wishes of your family
- The quality of your life
- The cost of your care
You should know that your physicians, nurses and other caregivers at Tufts Medical Center will always provide comfort care and treatment for pain.
In addition to the information contained in this packet, the hospital has a number of policies that address the manner in which patients’ rights are implemented, including the following: Policy on Informed Consent, Do Not Resuscitate Orders, Continuing Care of Patients with a DNR Order, and Refusing Blood Transfusion on the Basis of Personal Belief.
Social workers and religious counselors are also available at the hospital to speak with you further about these issues. If you would like further information about these policies, please ask your physician, nurses or other health care providers at the hospital.
Summary of Massachusetts law on medical decision making
This document summarizes rights you have under Massachusetts law to make decisions about your medical care, including the right to accept or refuse medical or surgical treatment, and to complete a Health Care Proxy.