MEDICAL TREATMENT AND DISCHARGE PLANNING* Informed consent for medical treatment (including end-of-life care), following a treatment plan, safe discharge or transfer
Options Advance directive for health care Surrogate decision-making Medical Order for Life-Sustaining Treatment (MOLST) Withholding or withdrawal of medically ineffective treatment Home and Community-Based Services and informal options
Observations and Notes
*See Appendix E for the Maryland Attorney General’s resources for health care professionals and facilities. Competent adults have the right to make decisions about their own medical care. This includes the right to refuse treatment. In this context, “competent” means someone who is at least 18 years old and who has not been determined to be incapable of making an informed decision. When providing information to a patient about their care options, consider the personal
is any individual who is over the age of 18, who understands the purpose and effects of an advance directive, and who has not been deemed incapable of making an informed decision. An advance directive can be written or electronic. It can also be made orally to a health care provider. There are requirements for creating an advance directive and who can serve as a health care agent. The Maryland Attorney General’s Office also has resources for individuals and health care providers. WATCH VIDEO SCAN ME A health care provider can turn to a patient’s health care agent or refer to their living will if a patient’s attending physician and a second physician certify in writing that a patient is incapable of making informed decisions. If the patient is unconscious, only the written certification of their attending physician is required. Md. Code, Health-General Art., § 5-601 et seq. Surrogate decision-making. If the patient is incapable of making informed decisions about their medical care and does not have an advance directive for health care or their health care agent is unavailable, a health care provider can turn to a surrogate decision-maker to make medical decisions on the patient’s behalf. Maryland law defines who surrogates are and their priorities (a provider must start at the first level of priority and cannot move to the next unless
decision-making options discussed above and ensure compliance with relevant state and federal laws. Provide information in a format that is accessible to the patient. If the patient is incapable of making an informed decision about their medical treatment, look to any arrangements the patient made before losing that ability and any available legal representatives. Advance directive for health care. Sometimes referred to as a “health care power of attorney” or “medical power of attorney,” these are instructions for how medical decisions will be made or the types of treatment a person will receive if they later become unable to make their own decisions. An advance directive can appoint a health care agent who is authorized to make medical decisions during any period the person is unable to make their own informed decisions. Health care agents are sometimes called medical powers of attorney or health care proxies. An advance directive can also include a “living will,” which states the person’s treatment preferences, including their wishes regarding life support, CPR, ventilators, feeding tubes, and other life-sustaining treatment. Any competent person can voluntarily create an advance directive. In this context, a ‘competent person’
someone is not available).
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