Advance Directives

The Advance Directive is a document that gives instructions about one’s wishes regarding health care. The Health Care Proxy and the Living Will are two components of the advanced directive. Patients receive the same quality of health care whether or not they have completed one or both of these forms.

If a patient becomes unable to make decisions and does not have an advance directive, a family member or other person close to the patient may be asked to make decisions based on what they believe the patient would want. For patients under age 18, a parent or guardian usually makes decisions about their medical care.

Completed Health Care Proxy forms or other types of advance directives can be given to one's doctor, nurse, or admitting officer, and a copy can be placed in one's medical record as well. 

Health Care Proxy

Under Massachusetts Health Care Proxy Law, a patient can name another person to make decisions about health care for that patient. This person becomes the patient’s health care agent. He or she may act for the patient only if the doctor determines in writing that the patient is unable to make or communicate personal health care decisions. The agent would then have the legal authority to make all health care decisions for the patient, including decisions about life support treatments. He or she would be entitled to information and records from the doctor to help make decisions.

The Health Care Proxy Law also allows the patient to put limits on the agent's authority, such as specifying what types of medical care the patient would or would not want. The patient can name an agent by completing a Health Care Proxy form, which is available in the admission packet or upon request from a nurse. Before you complete the form, it’s a good idea to discuss the matter with your doctor, with family members, and with the person you’ve named as your health care agent.

Living Will

A Living Will provides doctors, family members, and others close to a patient with written instructions describing the patient's views and choices about possible future medical treatment. However, note that the Living Will may not carry the same legal authority as a health care proxy.

Ethics Advisory Committee 

When someone is called upon to make a  health care decision for a loved one, this can be a confusing and frightening responsibility. NSMC provides an ethics consultation to assist individuals in situations in which they are experiencing moral or ethical dilemmas around patient care with no easily identified solutions.

The Ethics Committee members are prepared to listen and respond. They can help get all the facts needed to make a decision, and they can offer feedback and suggestions based upon ethical principles. They will not tell anyone what to do; however, they will make recommendations. Patients, families or members of the care team may initiate ethics consultations. To get in touch with the Ethics On-call consultation team, please call or ask a nurse or physician to call 978.354.2099.