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Advanced Directives for Cryonics Institute Members
Advance Directives usually describe documents created in
advance of someone being incapable of making decisions for
him or her self, although still legally alive. DNR (Do Not
Resuscitate) could also be called an Advanced Directive, but
it is an order by a physician (not the patient) not to
resuscitate if a person goes into cardiac or pulmonary
arrest. An Anatomical Donation or a
Certificate of Religious
Belief against autopsy are also forms of Advance Directives,
although these are instructions directing post-mortem
actions. The latter is especially valuable in states that will
only stop an autopsy on religious grounds. (The Society for
Venturism is a pro-cryonics religion which can be used against
autopsy: http://www.venturist.org)
Most commonly, "Advance Directive" refers to a Living Will
and Durable Power of Attorney for Health Care (or called Health
Care Surrogate Designation in Florida, for example). A Living
Will is a Will giving directions in advance of a condition
of being unable to communicate or give directions while still
alive. A Durable Power of Attorney is a Power of Attorney
that remains in effect (is "durable") after a person has
become incapacitated.
It is probably best for the same identical instructions to
be placed in a Living Will and in a Durable Power of
Attorney for Health Care (Medical Surrogate appointment).
The Living Will defines the wishes and the Medical
Surrogate is the living agent who is empowered to insist
upon those wishes being carried-out. For simplicity the
Medical Surrogate can be directed to ensure that the
wishes specified in the Living Will are carried out.
The US federal Patient Self-Determination Act requires
health care facilities that receive Medicaid and Medicare
funds to inform patients of their rights to execute
Advanced Directives. You can use an Advanced Directive
to clearly stress your desire to be cryopreserved
and for creating optimal conditions for your cryopreservation
at the time of your legal death. You can include contact
information to the Cryonics Institute (with your Member ID
number). As long as you are conscious and can communicate,
you can make your wishes known, but when you are still living
but cannot communicate, the Advanced Directive takes over.
You should discuss your Advance Directives with your
physician, lawyer and relatives to be clear that they
can see your desires in writing and understand them. Copies
should be in your file at the Cryonics Institute. You should
ensure that a Medical Surrogate (Durable Power of Attorney)
does not benefit financially from a failure to cryopreserve.
You should appoint two or three Medical Surrogates (trusted
friends or relatives) in prioritized order in case your first
choice is not available at the time of need. In some states
these documents expire after seven years, so they may require
reaffirmation.
For Americans using the Advance Directives of your specific state
will allow you to customize documents with which local medical
personnel are already familiar. On-line access to the Advance
Directives forms of every state is available from both Caring
Connections:
http://www.caringinfo.org/stateaddownload
and the US Living Wills Registry:
http://www.uslivingwillregistry.com/forms.shtm
A major problem with Advanced Directives is that they are not
always readily available when needed. That problem has now been
addressed by the US Living Will Registry, a privately-held
organization that electronically stores Advanced Directives for
24/7 access on the World Wide Web. To maintain privacy, the
Registry is only available to health care providers, such as
hospitals and physicians. The service is available without cost,
but to use it you must register. Once registered you are given
a Registry number and labels with the Registration number that
can be attached to your driver's license and insurance card.
Read the information on their FAQ page:
http://www.uslivingwillregistry.com/faq.shtm
and then go to the How to Register page:
http://www.uslivingwillregistry.com/register.shtm
As an example Medical Surrogate document, there is a
standardized Durable Power of Attorney for Health Care for
Michigan on the University of Michigan Health System website
accessible from the US Living Wills Registry:
http://www.med.umich.edu/1libr/aha/umlegal02.htm
The NHPCO standardized form for Michigan presented includes
such language as stating that in a terminal or "minimally
unconscious condition" that
I direct that treatment be limited to measures to keep me
comfortable and to relieve pain, including any pain that
might occur by withholding or withdrawing treatment...
However, I do want maximum pain relief, even if it may
hasten my death.
Although there is space for additional information, the
emphasis may not be appropriate for a cryonicist. The
Michigan form for Medical Surrogate at the US Living Wills
Registry simply allots space allowing a person to state
exactly what she or he would want. As an example, following
the words
"My specific wishes concerning health care are the following:"
a Cryonics Institute Member might put the following:
I have made arrangements to be cryopreserved with the
Cryonics Institute, so please contact them at emergency
number 866-288-2796 or Jim Walsh at 586-293-3390 telling
them I am Member CI-24 and ask for instructions. I wish
for life support to be continued unless my recovery is
unlikely and maintenance on life support would be damaging.
If there is no hope for my recovery do not remove life
support until a qualified health professional can promptly
pronounce death and a funeral director or cryonics rescue
team can promptly apply cooling and other cryonics
procedures, including injection with anti-coagulant,
such as heparin. Autopsy is against my religious belief.
"Religious belief" is being used in the broadest meaning,
which can include Venturist, confused/uncertain, agnostic,
pantheist, pagan or atheist. Certain states will only
forbid autopsy if it is against religious belief. (See
Avoiding Autopsy
for Cryonics.) Members may
want to say more about pain, state that they are Orthodox
Jewish, etc. Be sure that the instructions are what you are
most comfortable with -- do not be satisfied with using
words chosen by others if they do not entirely match your
own wants.
Canadians should look at the
Power
of Attorney for Personal Care on the
Cryonics Society
of Canada website.
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