Questions on Advance Care Planning with Dr. BJ Miller

Our podcast is hosted on Spotify and Anchor.

Advance care documents are tricky to complete if you don't understand the context or consequences of the medical decisions you are asked to make. What is a health care proxy, and what does the role entail? Do you want artificial nutrition when you can no longer feed yourself? How about a ventilator? How do you feel about being in an ICU? Do you need a POLST or DNR form? In this discussion, BJ Miller goes over the basics of advance care planning and answers questions from attendees on many of the variables.

Show Notes:

0:00 Introduction

2:15 Advance Care Planning - a process where you state your wishes for your own future care

3:10 The advance directive form, every state has it’s own - what’s in it? Organ donation, life support, artificial nutrition

6:00 Designating a healthcare proxy in an advance directive form, also called a durable power of attorney for healthcare

10:27 The POLST Form: Physician’s Order for Life Sustaining Treatment (also goes by other names like MOLST)

12:56 The DNR Form: Do Not Resuscitate, also called “Allow Natural Death”

14:40 What is “Full code”? The opposite of “DNR” order

15:15 Advance care planning requires conversation with your close circle, it’s not just a form

17:00 Important distinctions and options around organ donation: what can you donate if you die at home vs. the hospital?

19:33 Donating your body to science: participating in a “willed body program”

20:51 What happens if you don’t have an advance directive?

25:35 Writing care and handling instructions for yourself

28:05 What is the difference between an advance directive and a POLST?

31:00 Who should have a POLST?

32:10 What happens when there’s a doctor’s order in a patient’s chart, but an advance directive is at home? Which information gets respected?

35:50 Estate planning, probate and how they fit into the advance care planning process.

36:29 What happens when a medical team doesn’t follow an advance directive?

40:43 What do people need to know about CPR: the process and CPR medallions

44:19 What is the timeline between cessation of breathing and brain damage?

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