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So like as an example, in New York State, if someone has no healthcareproxy that they’ve designated, there is a legal structure by which we can assign a surrogate, whereas other states don’t have that same structure. Let’s say they’re in the ICU now on a ventilator. Should we keep them on the ventilator?
And for a few reasons, which I’m sure we’ll get into, I think it’s probably most effective upstream of the acute care setting, more in the nursing home setting or for patients who are not presenting in the hospital or emergency department setting. It would have a CPR section and then it would have a healthcareproxy section.
I think one of the challenges, especially about liver, is it doesn’t have a dialysis, it doesn’t have an ecMo, it doesn’t have a ventilator. Sarah 24:24 See, I usually always present it as these are things we should think of. Sarah 24:19 Well, I don’t know. Amy 24:21 For me, I always.
And now ICU care has flourished, and we can keep people alive in the sense that their heart is beating and we can sustain their ventilation and circulation. For example, I had another patient in the ICU who she was on a ventilator. ICU care was pretty rudimentary. It’s certainly not common in my practice.
You may also want to designate a healthcareproxy, who will be responsible for making sure your wishes are carried out. What Items Should Be Present In Your Living Will? This person is known as a healthcareproxy or durable power of attorney for healthcare. Who you want to make decisions on your behalf.
But I do think POLST, which I conceptualize as an advance care planning tool, really sits in between those worlds of decisions that are relevant for the present versus the few future. I don’t need a checkbox form, I don’t need to know about CPR or mechanical ventilation. That’s not unique to POLST as an order.
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