你有你的临终计划吗？四月十六日是美国医疗保健决定日

April 16 is National Healthcare Decisions Day (NHDD).


中美文化差别极大，特别是在死的问题上。中国人忌讳谈死，认为不吉利。但美国人却常常把死挂在嘴上，不仅不怕死，而且对死亡和临终问题还有计划和遗嘱。孰是孰非？我认为在处理死的问题上，还是美国人高人一筹。

" 'Would you like to discuss your end-of-life plans today?' I ask my patients this question, though not as often as I'd like. Talking about death may be uncomfortable, but it's a conversation that needs to happen more often." --Kevin Pho, MD.

Dr. Kevin Pho's assertion is one that may have been cause for pause for patients and families years ago. However, as people continue to become educated on the value of advance care planning through initiatives like National Healthcare Decisions Day (NHDD), it is a sentiment that is garnering the thought and consideration it deserves amongst medical professionals, patients and families.

And, with NHDD just one day away -- on Saturday, April 16th-- Pho has penned an incredibly timely piece on the subject. In his most recent column, published several days ago in USA Today -- Politics mustn’t silence end-of-life talks -- Pho expounds on the importance of advance care planning for a wide readership.

We hope this impactful op-ed will complement the many NHDD events across the nation and inspire people from all walks of life to not only 'have the talk,' but walk the walk by completing their advance directives.

Moved to complete your own advance directive or to help your loved ones engage in advance care planning? Check out tips on how to start the process in 'NHDD Blog Rally 2011' and take the NHDD 2011 Pledge featured in the website sidebar.

Get an Advance Directive

What is an advance directive?
All adults can benefit from thinking about what their healthcare choices would be if they are unable to speak for themselves.  These decisions can be written down in an advance directive so that others know what they are.  Advance directives come in two main forms:

• A "healthcare power of attorney" (or "proxy" or "agent" or "surrogate") documents the person you select to be your voice for your healthcare decisions if you cannot speak for yourself. 
• A "living will" documents what kinds of medical treatments you would or would not want at the end of life.

How can I learn more about advance directives/advance care planning?

The links below explore a variety of resources to help you make, discuss and document future healthcare wishes and decisions. 

• AARP: End-of-Life Planning
• Advance Care Planning Day Initiative:  Advance Care Planning
• Aging with Dignity: Five Wishes
• Amedisys: Discussion Guide for Advance Care Planning
• American Bar Association: Tool kit for Health Care Advance Planning; 10 Legal Myths about Advance Medical Directive  
• American Health Lawyers Association: Guide to Legal Issues in Life Limiting Conditions; Loving Conversations (video) on Advance Care Planning 
• American Hospital Association: Put It In Writing
• Caring Connections: Advance Care Planning; Financial Information; Planning Ahead Checklist; Free Brochures
• Center for Practical Bioethics: Caring Conversations Workbook  
• Cancer.net: Advanced Cancer Care Planning Workbook
• National Association of Social Workers: Advance Care Planning and Psychiatric Advance Directives 

Where can I get an advance directive?
Aging With Dignity (Five Wishes)  

The Five Wishes document helps individuals express care options and preferences. The advance directive meets the legal requirements in most states and is available in 20 languages for a nominal fee. Order online or call 850.681.2010.

Caring Connections

Caring Connections offers free, state-specific advance directives for all 50 states and DC that meet the legal requirements for each state.  Download individual copies for free or call 800.658.8898 to have a copy mailed to you.

Center for Practical Bioethics

Caring Conversations is a workbook to help individuals and families communicate with each other about their healthcare preferences and contains advance directive documents.  These forms are valid in every state when notarized and signed by two witnesses.  Download for free or call800.344.3829 to order.  

Compassion and Choices

Compassion & Choices offers an advance care planning tool kit and state-specific advance directive materials.

Lifecare Advance Directives

The Lifecare Advance Directive website offers free state-standard advance directives for all 50 states, the District of Columbia, and four major United States territories (American Samoa, Guam, Puerto Rico, and the Virgin Islands). Research validated comprehensive advance directies, as well as completion guides, agent guides, and other important advance directive support documents are also available.

MedicAlert Foundation
The MedicAlert Foundation offers emergency medical information and identification services including Do Not Resuscitate medical IDs and option to store advance directives for all 50 states.

National Resource Center on Psychiatric Advance Directives

National Resource Center on Psychiatric Advance Directives offers general and state-specific information on psychiatric advance directives.

Organ Donation Choices: http://www.organdonor.org/ or http://www.donatelife.net/

Project Grace

Project Grace offers a free Advance Care Planning Document that is legally valid in states that do not require forms to be notarized. Download for free, or call 877.99.GRACE to order a copy. 

The Will to Live Project

The Will to Live Project  provides state specific forms for designating an agent and stating healthcare wishes. 

The Patients’ Rights Council

The Patients’ Rights Council offers a durable power of attorney document (in either multistate or state-specific versions) that expressly defines and prohibits euthanasia.

所有跟帖： 

• 有临终计划! -smeagol1- ♀ (0 bytes) () 04/15/2011 postreply 21:31:15

• 不错！我想绝大多数中国人 -JoshuaChow- ♂ (21 bytes) () 04/15/2011 postreply 21:34:25

• 我做的是医疗照护事前指示与安宁疗护 -smeagol1- ♀ (172 bytes) () 04/15/2011 postreply 21:41:17

• 佛教和生命轮回，在死的问题上是 -JoshuaChow- ♂ (101 bytes) () 04/15/2011 postreply 21:49:13

• 平常没信仰的临时抱佛脚还有用吗? -weston- ♀ (0 bytes) () 04/15/2011 postreply 21:58:47

• 信仰这东西常常是顿悟的，死前 -JoshuaChow- ♂ (69 bytes) () 04/15/2011 postreply 22:03:09

• :)))))))))))) -smeagol1- ♀ (0 bytes) () 04/15/2011 postreply 22:10:59

• 同意。顿悟越早越好。 -jck6- ♀ (0 bytes) () 04/16/2011 postreply 05:08:31

• 嗯，任何时候都不迟，不过还是越早越好~ 嘿嘿 -jck6- ♀ (0 bytes) () 04/17/2011 postreply 04:49:21

• 嗯，信仰的门永远是敞开的。不过还是越早越好~ 嘿嘿 -jck6- ♀ (0 bytes) () 04/17/2011 postreply 04:53:18

• 真正顿悟才有用。临时假装的没用。 -jck6- ♀ (0 bytes) () 04/18/2011 postreply 17:26:03

• 真正顿悟才有用。 -jck6- ♀ (0 bytes) () 04/18/2011 postreply 17:31:29

• 有用，可很多人临终抱不上佛脚 -smeagol1- ♀ (0 bytes) () 04/15/2011 postreply 22:10:34

• 谢谢提醒。朋友的太太去世没遗嘱,有一单名银行账户5千刀,申请继承后扣得只剩几百。 -ooopsss- ♂ (0 bytes) () 04/15/2011 postreply 22:13:39

• 单名银行帐号应该像IRA一样,放上第一继承人:配偶,第二继承人:子女.这样就应该没事了吧。 -swj2000- ♀ (0 bytes) () 04/15/2011 postreply 22:42:08

• 很多人都不会这样细心，银行职员有时会提醒一下。 -ooopsss- ♂ (0 bytes) () 04/15/2011 postreply 22:45:10

• 这个问题太复杂，有遗嘱也可能要交遗产税和手续费 -dudaan- ♂ (235 bytes) () 04/16/2011 postreply 05:24:06

• 人人怕死包括美国人。只能说他们在处理死和善后比较开明。 -华灜- ♀ (0 bytes) () 04/15/2011 postreply 23:44:54

• 美国老人独立生活能力强，自立，远比中国老人 -JoshuaChow- ♂ (172 bytes) () 04/16/2011 postreply 14:08:32

• 嗯，发达国家的老人普遍比较独立是事实！促成的因素很多如福利保障，经济独立 -华灜- ♀ (45 bytes) () 04/16/2011 postreply 16:52:54

• 信仰也是举足轻重的！只要有 -JoshuaChow- ♂ (57 bytes) () 04/16/2011 postreply 19:24:47

• 嗯，信仰的门永远是敞开的。越早越好~ 嘿嘿 -jck6- ♀ (0 bytes) () 04/17/2011 postreply 04:58:50

• 在死的问题上，感觉有信仰的人对此的心态更放得开。中国以前有信仰的人很多，现在 -woth- ♀ (39 bytes) () 04/16/2011 postreply 11:23:54

• 美国人死后开追悼会的名字也很响亮，叫 -JoshuaChow- ♂ (82 bytes) () 04/16/2011 postreply 14:17:06

• 中文的庆祝和英文的Celebrate的涵盖不一样，英文可以欢乐可以严肃 -dudaan- ♂ (0 bytes) () 04/17/2011 postreply 05:24:25

• 这个厉害！我有感觉到，可咋就没想到要说出来：（ -华灜- ♀ (0 bytes) () 04/18/2011 postreply 01:21:16

• 那叫追思会 -jck6- ♀ (0 bytes) () 04/17/2011 postreply 10:13:56