Advance Directives & End-of-Life Planning
Top Concerns & Questions
Learn from these top questions and concerns when making an Advance Directive.
I am healthy, why do I need an Advance Directive?
An accident or serious illness can affect anyone at any age. Thinking about this in advance and creating an Advance Directive gives the person the chance to discuss options and concerns with your family and physician if an accident or illness prevents the person from making medical decisions in the future.
Don't all Advance Directives mean "Don't Treat"?
Not only do Advance Directives dictate what measures a person does not want, they also include the treatment options a person would like to receive. It is a chance for a person to express his or her personal values and wishes for health care decisions. Even if life-sustaining treatments are limited by your Advance Directive, you will still receive other treatments that will help you with pain control and comfort.
What is life-sustaining treatment?
Life-sustaining treatment maintains life when an organ or body system ceases to function at a level adequate for survival. Life-sustaining technologies include antibiotics and other medications, IVs, and machines or medical procedures that can keep a person alive.
What about pain and suffering?
Regardless of any decision about medical treatment, including life-sustaining treatment, the person will continue to receive appropriate medical and nursing care necessary to ease pain and suffering.
What about nutrition and hydration?
Life can be sustained by liquid food and water given intravenously or by inserting a tube through the nose or stomach. This is called “medically assisted nutrition and hydration.” Under special circumstances, medically assisted nutrition and hydration may be determined to be a greater burden than benefit to the person and thus may be withheld or withdrawn. If food or water no longer gives comfort and a person is imminently dying, or the person’s body can no longer digest food, a Catholic health care institution would honor the person’s request to not start, or stop, artificial hydration and nutrition.
What is a No Code or Do Not Resuscitate (DNR) order?
Every person admitted to an Avera facility will receive life-sustaining treatment, including CPR, unless a decision not to code (not to revive from apparent death) was previously made. A “No Code” or “DNR” order is made only after thoughtful discussion between the physician, a competent person and any others involved in the decision-making process.
If a decision is made that the person should not be revived from apparent death and the physician authorizes a “No Code” or “DNR” order, it does not mean that all medical and nursing care will be withheld. Supportive care will continue to be provided.
Can the individual appointed make a decision contrary to my express wishes or against medical practice?
Most state laws require the individual to consider the recommendation of the attending physician, the decision that the person would have made if the person then had decisional capacity, if known, and the decision that would be in the best interest of the person. Decisions by the individual appointed must be in accordance with accepted medical practice and, at Avera facilities, with the Ethical and Religious Directives for Catholic Health Care Services (ERDs).
Likewise, in order to be followed at an Avera facility, your Advance Directive must be in accordance with accepted medical practice and the ERDs.