Introduction

This 2001 update of the Advance Directives Manual is an expansion of the previous version and contains materials to assist you in meeting the requirements of the law on advance directives, surrogate decision-making and organ procurement.

Federal and state law on advance directives is introduced in Section One. Section One also includes information on Medicare Conditions of Participation for hospitals and the Joint Commission on Accreditation for Healthcare Organization's standards on advance directives, pain management, surrogacy and end of life care. The Washington state regulations specific to nursing homes are also summarized in Section One.

In addition to introducing the law on advance directives, this manual includes guidelines for developing hospital policies and procedures, creating patient information materials and educating the community about advance directives. The information is intended to assist hospitals in meeting the requirements of the law.

The resource list in Section Two provides guidance for providers and patients faced with end of life decision-making. The organizations listed provide information on end of life care, and some pertain specifically to introducing ways in which providers can best provide palliative care. General information on advance directives can also be attained from many of these organizations.

As part of the manual's 2001 revision, the law on surrogate decision-making and organ procurement is addressed. Relevant statutes and general guidelines on how to approach these areas of the law are discussed in Sections Four and Five, respectively.

This revision also includes information on the Physician Orders for Life-Sustaining Treatment program, which uses a designated physician order form to make a patient's end of life care decisions known. This program is introduced in Section Six.

next page ›››