Pacific Mutual Puts Health Care Decisions in Patients’ Hands
The state’s largest insurance company Monday will begin mailing more than 200,000 legal forms to Californians that give doctors guidelines about life support measures, organ donation and autopsies.
A spokesman for the California Medical Assn. said he believes that Pacific Mutual Insurance Co., based in Newport Beach, is the first insurance company in the state to begin a mass distribution of the forms, called Durable Power of Attorney for Health Care. The state law establishing that power, which went into effect on Jan. 1, 1984, also allows individuals to designate someone to make those decision for them, for up to seven years, if they are capacitated.
Sponsors said the purpose of the legislation was to make certain the wishes of patients with no family were made plain to doctors and to eliminate confusion over who could make important decisions. Unlike the so-called “living will,” the power of attorney has the force of law.
In the year following the law’s enactment, the bioethics committee of the California Medical Assn. developed and copyrighted the eight-page document, which does not require a lawyer’s help to complete, and distributed more than 200,000 to physicians, churches and health care organizations. The association also wrote a pamphlet, “Your Health Care: Who will decide when you can’t?”
Copies of the form are available, along with a wallet identification card, for $1.50 each, through the association’s publishing subsidiary, Sutter Publications, Inc., P.O. Box 7690, San Francisco, Calif. 94120-7690.
More than 2,000 employees and brokers of Pacific Mutual already have received copies, according to Harry G. Bubb, the company’s chairman.
Policy holders will also receive a letter referring them to California Health Decisions, a nonprofit organization in Orange which specializes in issues of medicine and ethics and conducts 90-minute workshops explaining the document.
“It requires more explanation than just getting it,” said Ellen Severoni, the group’s executive director. “Some very interesting questions arise.”
The primary goal in distributing the form, Severoni said, was for people to have “better control over their health care decisions.”
Almost anyone, apart from the patient’s doctor or an employee of the doctor, can be designated to make the decisions.
With regard to life support, a person can choose from three levels of care:
- Prolongation “to the greatest extent possible without regard to my condition, the chances I have for recovery or the cost of the procedures.”
- Treatment “to be provided unless I am in a coma which my doctors reasonably believe to be irreversible.”
- No continued treatment “if the burdens of the treatment outweigh the expected benefits,” with consideration of “the relief of suffering.”
The patient can also state wishes for organ donation and autopsy, or leave these decisions to the designated agent. But the agent can only act in those matters and may not consent to commitment to a mental facility, shock treatments, pyschosurgery, sterilization or abortion.
The forms must be completed by a California resident, at least 18 years of age, and must be notarized or witnessed by two adults known to that person, at least one of whom is not a relative or eligible to inherit. Copies should be sent to the agent and the doctor.
