Life Sustaining Treatment

Pennsylvania State Law Requirements

Questions about medical care at the end of life are a great concern today, partly because of the growing ability of medical technology to prolong life and partly because of highly publicized legal cases involving comatose patients whose families wanted to withdraw treatment.

The Patient Self-Determination Act of 1990 (PSDA 1990) requires that hospitals inform patients of their right to withhold or withdraw treatment after reaching an advanced stage of a terminal illness or permanent unconsciousness according to hospital policy.

Pennsylvania passed a law in April 1992 that validates health care advance directives (living wills or durable powers of attorney for health care) that will help guide physicians in making decisions about life-sustaining treatment.

Requirement of terminal condition or permanently unconscious: Declarations go into effect only if a patient is suffering from a “terminal condition” if he/she has an “incurable and irreversible medical condition in an advanced state, which will result in death regardless of continued application of life-sustaining treatment.”

It is the responsibility of the patient’s attending physician to determine that the patient is in a terminal condition or is permanently unconscious. Declarations do not go into effect if a patient has the capacity to communicate to his/her physician. If that is the case, decisions have always and should continue to be made jointly by the doctor and patient.

Warren General Hospital’s Policy

It is most important that you discuss your choices and concerns about health care decisions, that is, to accept, withdraw, or refuse medical care and /or treatment with your physician prior to admission to the hospital, and that you share your decisions with your family. These decisions will be respected by Warren General Hospital.

Warren General Hospital will provide life-sustaining treatment, including resuscitation efforts, to patients for whom it is indicated unless there are specific physician orders to the contrary in the medical record.

Upon admission you will be asked if you have completed an advance directive. The advance directive is kept as part of your medical record once completed. You may change or revoke your advance directive at any time. Social Services will assist you.

For patients that are unable to make their own decisions about life-sustaining treatment, the patient’s family will be asked to make them. Patient’s admitted to WGH will not be discriminated against regardless of whether or not they have an advance directive.

For more information, see “Advance Directives”.