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August 19, 2013

Do not resuscitate!

How do you tell people what you really want?

In early March, a story and controversy surrounding the death of an 87 year-old woman who did not make her end of life wishes known in writing was covered in the news. The article by Lisa M Krieger, “CPR Flap Could Have Been Avoided” in the San Jose Mercury News discusses an important form which many people do not know about or confuse with an Advanced Health Care Directive.

Should you become unconscious and unable to choose not to accept certain medical procedures, paramedics and doctors are not required to follow a DNR for in your wallet or language in the standard form use to name an agent for Health Power.

If you are terminally ill or frail elderly, there are three documents that will allow someone you choose to help you in your final hours. Otherwise, the hospital, doctors, paramedics and all other persons will follow standard medical protocol to keep your body functioning.

The Advanced Health Care Directive

Many people think an Advanced Health Care Directive will be sufficient. The purpose of this document is to name a person who can make health decisions for you when you are unable to do so. This is why the hospital wants one on file when you are admitted. Doctors and medical personnel cannot make this decision for the patient. While important, since the Advanced Health Care Directive is prepared by an attorney not a doctor, paramedics and emergency personnel do not need to follow any particulars included on this form. In addition, in an emergency there is not time for them to read a legal manifesto.

Still, everyone over the age of 18 should have one. It is best if prepared by an attorney with estate planning package, but the State of California also offers a free form at: http://ag.ca.gov/consumers/pdf/ProbateCodeAdvancedHealthCareDirectiveForm-fillable.pdf

The HIPAA Authorization Release

As people age or when they are ill, it can become difficult to manage health care matters – from remembering and getting to doctor appointments to asking the doctor pertinent questions. If you have ongoing health issues, are terminally ill, or elderly, you should also consider signing a HIPPA release form to allow your health agent or another designated person to speak with your doctors about your health care needs. This can be given to more than one person and it is used even while you are competent and able to make your own decisions, so that someone else may also speak with your doctors. In the event that you need assistance with health care issues, a HIPPA release form is the only way that someone else can discuss your health need s with the medical community.

The Physician Order for Life Sustaining Treatment or “POLST”

The medical community has developed a solution to help people discuss their end of life wishes in detail with their doctor. It is one page, printed on pink pager and signed by your treating physician. I tell my clients to posit it on an entry wall or bedroom door so paramedics and others can see it.

This allows the paramedics to not perform CPR, should that be your wish.

Otherwise, once CPR is started and a person receives oxygen, the heart can continue even when the brain is no longer working. Once emergency resuscitation is started, only a POLST or a decision the named Health care agent can stop normal ICU and emergency life sustaining treatments.

You may contact me at michael@mdpfiduciary.com if you would like to see samples of the POLST form or HIPPA Release form.

As a notary and licensed professional fiduciary, I hope that you find this information helpful, both personally and professionally.

You might also like:

You only notarize twice… a story about an old man who dies in front of the notary.

Notary needed, but the signer is in a coma!



  1. Excellent coverage of an often overlooked subject – Thank You.

    Comment by Kenneth A Edelstein — August 19, 2013 @ 9:38 am

  2. Thank you 123 Notary for all you do!!!

    Comment by Connie Kuest — August 28, 2013 @ 10:03 pm

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