And Guide to Advance Directives and Living Wills
Virtua provides inpatient and outpatient care on a non-discriminatory basis. All patients are admitted and receive care without regard to race, color, creed, disability, religion, sex, national origin, or economic status. You have the right to be notified of your rights and how to file a grievance. Your patient rights include:
- To receive the care and health services that the hospital is required to provide by law.
- To receive an understandable explanation from your physician of your complete medical condition, recommended treatment, expected results, risks involved, and reasonable medical alternatives. If your physician believes that some of this information would be detrimental to your health or beyond your ability to understand, the explanation must be given to your next of kin or guardian.
- To give informed written consent prior to the start of specified, non-emergency medical procedures or treatments. Your physician should explain to you – in words you understand – specific details about the recommended procedure or treatment, any risks involved, time required for recovery, and any reasonable medical alternatives.
- To refuse medication and treatment after possible consequences of this decision have been explained clearly to you, unless the situation is life threatening or the procedure is required by law.
- To be included in experimental research only if you give informed, written consent. You have the right to refuse to participate.
- Pain Management - In addition to the above, you have the right to have your pain assessed and adequately managed.
Communication and information:
- To be informed of the names and functions of all healthcare professionals providing you with personal care.
- To receive, as soon as possible, the services of a translator or interpreter if you need one to help you communicate with the hospital’s healthcare personnel.
- To be informed of the names and functions of any outside healthcare and educational institutions in your treatment. You may refuse to allow their participation.
- To receive, upon request, the hospital’s written policies and procedures regarding life-saving methods and the use or withdraw of life support mechanisms.
- To be advised in writing of the hospital’s rules regarding the conduct of patient rights that includes the name and phone number of the hospital staff member to whom you can address questions or complain about any possible violation of your rights.
- To have prompt access to the information in your medical record. If your physician feels that this is detrimental to your health, your next of kin or guardian has the right to see your record.
- To obtain a copy of your medical record, at a reasonable fee, within 30 days after a written request to the hospital.
Cost of medical care:
- To receive a copy of the hospital payment rates. If you request an itemized bill, the hospital must provide one, and explain any questions you may have. You have the right to appeal any charges.
- To be informed by the hospital if part or your entire bill will not be covered by insurance. The hospital is required to help you obtain any public assistance and private healthcare benefits to which you may be entitled.
- To receive information and assistance from your attending physician and other healthcare providers if you need to arrange for continuing health care after your discharge from the hospital.
- To receive sufficient time before discharge to arrange for continuing healthcare needs. To be informed by the hospital about any appeal process to which you are entitled by law if you disagree with the hospital’s discharge plans.
- To be transferred to another facility only when you or your family has made the request, or in instances where the transferring hospital is unable to provide you with the care you need.
- To receive an advance explanation from a physician of the reasons for your transfer and possible alternatives.
- To be treated with courtesy, consideration, and respect for your dignity and individuality.
- To have access to storage space in your room for private use. The hospital must also have a system to safeguard your personal property.
You have the right to:
- Choose who may visit you during your inpatient stay, You have the right to choose who may visit you during your stay or treatment, regardless of whether the visitor is a family member, a spouse, a civil union or domestic partner (including a same sex domestic partner) or another type of visitor, as well as the right to withdraw such consent to visitation at any time.
- Virtua will not restrict, limit, or deny visitation privileges based on race, creed, color, national origin, ancestry, nationality, age, marital status, familial status, religion, sex, gender identity or expression, affectional or sexual orientation, disability or source of lawful income.
- Visitors are asked to respect the patient’s need for privacy and rest as well as the need for privacy or rest of another patient in a shared room. Visiting may be limited if the presence of a visitor endangers any patient, disrupts operations, or is medically or therapeutically contraindicated. Children are allowed to visit, but should be attended at all times. For the benefit of our patients and staff, people who are ill should not visit. Check with your provider for any additional information you may need regarding visitation.
Freedom from abuse and restraints:
- To have freedom from physical and mental abuse.
- To have freedom from restraints, unless they are authorized by a physician for a limited period of time to protect the safety of you or others.
Privacy and confidentiality:
- To have physical privacy during medical treatment and personal hygiene functions, unless you need assistance.
- To confidential treatment of information about you. Information in your records will not be released to anyone outside the hospital without your approval, unless required by law.
- To treatment and medical services without discrimination based on age, religion, national origin, gender, sexual preferences, handicap, diagnosis, ability to pay, or source of payment.
- To exercise all your constitutional, civil, and legal rights.
- To contract directly with a New Jersey licensed registered professional nurse of your choosing for private professional nursing care during your hospitalization. A list of private duty agencies is available in the Nursing Office.
- To present a complaint to or request a formal grievance review from a designated hospital staff member. To receive a response in a reasonable period of time. You may request a formal grievance review regarding the quality or appropriateness of care and/ or utilization issues by contacting the facility Patient Relations representative.
You may also contact the New Jersey Department of Health directly regarding any complaint or grievance you might have. The New Jersey Department of Health Complaint Hotline telephone number is: (800) 792-9770.
You may also call the Joint Commission at (800) 994-6610 from 8:30 am to 5 pm (Central time), weekdays. Or write to them:
The Joint Commission
One Renaissance Boulevard,
Oakbrook Terrace, IL 60181.
The list of patient rights is an abbreviated summary of the current New Jersey law and regulations governing the rights of hospital patients. For more complete information, consult New Jersey Department of Health regulations at N.J.A.C. 8:43G-4, or Public Law 1989- Chapter 170, available through the administration offices at all Virtua hospitals.
The ability to provide quality care and treatment requires each patient’s cooperation. You, as the patient, are responsible to:
- Provide accurate and complete information regarding present illness, past medical history, and other matters relating to your health
- Report any other changes in your condition to the physician
- Make known whether you satisfactorily understand your health problems and/or any possible treatment that may be administered
- Follow the treatment plan recommended by the physician and to assist nurses and other medical personnel in the adherence to instructions
- Accept responsibility for your actions and the results if you refuse treatment or do not follow instructions
- Fulfill the financial obligations of your healthcare promptly
- Follow the hospital’s rules and regulations affecting your care, conduct, and safety; be considerate of the rights of other patients and hospital personnel; control the noise and conduct of your visitors and the security of your personal belongings and the property of others
While decision-making should continue to be between the patient, family and physician, each hospital has a Bioethics Committee available for consultation in an advisory capacity. Consult the committee if you have concerns regarding end-of-life care, pain management/ comfort care, advance directives or issues regarding spiritual care. If you wish to speak with someone from the Bioethics Committee, contact Patient Relations or ask for the Nursing Supervisor.
What is the purpose of an advance directive?
If a serious medical condition prevents you from communicating your treatment decisions, the responsibility for making decisions about your care will fall to your family, physician, hospital or sometimes a court of law. Preparing an advance directive, however, allows you to express your wishes regarding end-of-life treatment when you are unable to choose or refuse various types of medical care for yourself.
This information explains your rights to make decisions about your own health care under New Jersey law, and your rights as a patient. It also tells you how to plan ahead for your health care if you become unable to decide for yourself because of an illness or accident.
What types of medical conditions and treatments are involved?
An advance directive is only implemented under specific conditions, when people are determined to be unable to make healthcare decisions or speak for themselves. Patients must have a terminal illness, or conditions that leave them in a persistent, vegetative state such as severe brain damage and coma before their advance directive would be implemented. Some of the more common treatments people may want to address when preparing an advance directive include: cardiac resuscitation, respirators or breathing machines, artificial or tube feedings, renal or kidney dialysis, antibiotic treatments, blood transfusions and surgery.
What should be considered before establishing an advance directive?
Prior to preparing an advance directive, people are encouraged to answer these questions based on their beliefs and backgrounds.
- Do you want any of the following medical treatments performed?
- Kidney dialysis if your kidneys stop working.
- Cardiopulmonary resuscitation or CPR if your heart stops beating.
- Assisted-breathing through a ventilator or respirator, which is a machine that breathes for you if your lungs are not working.
- Artificial nutrition if you cannot feed yourself.
- Artificial hydration if you are unable to drink fluids.
- What are your feelings about life-sustaining measures if you had a terminal disease?
- How do you feel about living alone and being independent?
- Do your religious beliefs affect your feelings about illness and death?
- Do you want to donate parts of your body at the time of your death? (This is called organ/tissue donation.)
- What would be important to you if you were dying e.g., physical comfort, relief from pain, presence of family members, etc.?
- Should your doctor make the final decision about needed medical treatments?
- Do you expect family, friends and others to support your medical decisions?
- Is there one family member who you know would respect your wishes that you would choose as your decision maker, healthcare proxy or representative?
- Are you comfortable signing a legal document that states who will make your medical decisions?
- Do you have any other medical wishes that you want people to know?
Can I change my mind?
An advance directive can be changed at any time, and does not become effective until the time when you can no longer make medical decisions for yourself and are terminally ill. Be sure to notify your proxy if your beliefs change.
Are there different types of advance directives?
An advance directive is a legal document, which anyone age 18 or older can have, that describes your medical wishes in the event that you were unable to make decisions for yourself. There are three different types of advance directives.
- Instruction directive or living will is a document that instructs healthcare providers about your medical choices, including treatments you do or do not wish to receive.
- Proxy directive or durable power-of-attorney is a document in which you name another person (proxy) to make healthcare decisions for you.
- Combined directive includes instructions about treatments you prefer or want to avoid, and allows you to pick a person to state your wishes for medical treatment.
Who should I talk to before filling out an advance directive?
While choices concerning life and death are personal ones, they also affect the people who are close to you. For this reason, it is often helpful to discuss your medical choices with your family, friends, spiritual advisor, physician, and proxy if you choose one. Questions about the kinds of medical procedures that are used when illness is severe and recovery unlikely can be best answered by your physician. While you may consult an attorney if you wish, it is not necessary.
Must physicians, family and others follow my advance directive?
Yes. Everyone responsible for your care must respect your decisions as stated in your advance directive. This is a legal document that must be signed, dated and witnessed by two people or notarized. The person you choose to be your proxy or healthcare representative must be at least age 18. If your doctor, nurse, or other professional, however, has a sincere objection to your decision to refuse life-sustaining treatment, he or she may have your care transferred to another professional who will follow your wishes.
What should I do with my advance directive?
You should give a copy to your family physician, healthcare representative or proxy, family member(s) and other people who are close to you. Bring a copy when you are admitted to a hospital, nursing home or other healthcare facility. Your advance directive becomes a part of your medical record. We ask you for a copy during each admission, to insure that we have the most current copy that reflects your wishes. Keep a copy of your advance directive in a safe place so it can be located if needed.
Do I need an advance directive to be treated or admitted to the hospital?
No. If you do not have an advance directive, it will in no way affect the quality of care you are provided. You do not have to fill out any of the advance directive forms that may be presented to you at a hospital, and you will still get medical treatment. Furthermore, your insurance company cannot deny coverage based on whether or not you have an advance directive.
How can I get a copy of an advance directive form?
If you need assistance or would like a copy of an advance directive form, please call one of the Virtua facilities below and ask for the Patient Relations Department.
- Virtua Camden Hospital
(856) 246-3598, ext. 63598
- Virtua Berlin Hospital
(856) 322-3555, ext. 23555
- Virtua Marlton Hospital
(856) 355-6555, ext. 56555
- Virtua Memorial Hospital
(609) 267-0700, ext. 43254
- Virtua Voorhees Hospital
(856) 247-3555, ext. 73555