Choosing My Patient Advocate - Saint Joseph Mercy Health System

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Unpublished Work (c) 2008 Trinity Health-Michigan
A BRIEF GUIDE TO ADVANCE CARE PLANNINGThank you for taking the time to learn about patient advocacy and advance care planning. There are twomajor roles - patient and patient advocate. Both roles are important. The patient must thoughtfully identifyhis/her goals and values and choose an advocate. The patient advocate needs to learn the patient’s goals andvalues as well as realize the responsibility involved.This packet contains three documents:1. “Brief Guide” (which you are reading now): This provides an overview of the process and instructions forcompleting the two forms (see numbers 2 and 3). We strongly suggest that both the patient and the PatientAdvocate read this guide and discuss it with each other.2. “Choosing My Patient Advocate”: This is the form the patient will complete to name and provideinstructions to the Patient Advocate.3. “Accepting the Role of Patient Advocate”: This is the form the Patient Advocate will complete indicatingthat he or she is willing to serve in that role.INTRODUCTIONAs an adult with the ability to make your ownmedical decisions, you can accept, refuse, or stopmedical treatment. If you lose the ability to makeyour own medical decisions (for instance, becauseof an accident or illness), someone else will haveto make those decisions for you. You can choosethe person you want to make those decisions – thatperson is called your “Patient Advocate” – and givethat person information about your preferences,values, beliefs, wishes and goals that will help himor her make the decisions you want made. The“Choosing My Patient Advocate” form (sometimescalled an Advance Directive) allows you to identifythe Patient Advocate you have chosen. It alsoinstructs your Patient Advocate so he or she can acton your behalf.It is important for both you and your PatientAdvocate to understand that your PatientAdvocate makes decisions only when you lackthe ability to do so. In Michigan, two physicians,one of whom should be your attending physician,have to examine you and declare that you lackdecision-making ability (also called decision-makingcapacity) before a Patient Advocate can act on yourbehalf.It is also important for you and your PatientAdvocate to know that by law in Michigan:• you can designate an alternate Patient Advocateto act in case your first choice of PatientAdvocate is unavailable, but at any giventime only one person can act as your PatientAdvocate;• your Patient Advocate must sign the formentitled “Accepting the Role of PatientAdvocate” (or a similar form) before acting onyour behalf; and• your Patient Advocate can make a decisionto refuse or stop life-sustaining treatment onlyif you have clearly expressed that he or she ispermitted to do so.– 1 –
Page 4 and 5: INSTRUCTIONS FOR “CHOOSING MY PAT
Page 6: - 4 -
Page 9: SECTION 4:SIGNING THE PATIENT ADVOC
Page 12: h. The patient may waive the right

Choosing My Patient Advocate - Saint Joseph Mercy Health System

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