Patient Self-Determination Act
Providence Alaska Medical Center promotes a patient's right to participate actively in health care decision making. Through education and inquiry about Advance Directives, we encourage patients to communicate their preferences and values to others. Such communication will guide others in the health care decision making for the patient if the patient is unable to do so. | An Advance Directive is a formal document written in advance of an incapacitating illness that states a patient's choices regarding health care if the patient becomes unable to make decisions. |
Download the Advance Directive Form
The suggested Alaska Advance Directive form contains two major important parts. First, the appointment of a health care agent, also called the Durable Power of Attorney for Health Care, and second, the instruction section called the Living Will or Health Care Directive. (see below for a definition of these terms)
• Download in Adobe® PDF format
• Download in MS Word format
• Download the Advance Directive, simplified version
Providence Alaska Medical Center appreciates having a copy of a patient's Advance Directives but does not require patients to create Advance Directives and does not discriminate against those who choose not to write Advance Directives. Providence Alaska Medical Center provides each adult individual admitted as an inpatient with written information about: • An individual's rights under Alaska state law to make decisions concerning medical care such as the right to accept or refuse medical or surgical treatment and the right to formulate an Advance Directive. • Written policies of the hospital concerning the individual's rights to make health care and Advance Directive decisions, and the implementation of such decisions. Providence Alaska Medical Center supports the goal of educating health care providers and the community about the value of Advance Directives and facilitates their appropriate use. | Definitions of Key Terms: | | Durable Power of Attorney for Health Care
A legal document in which a person gives authority for making decisions about his/her health care to someone else. The document is usually written so that this authority is given only if the person becomes unable to make decisions for him/herself. | | | Health Care Directive (Living Will)
is the part of the document in which a person can stipulate the kind of life prolonging medical care he/she would or would not want if terminally ill or permanently unconscious and unable to make medical decisions or speak for him/herself. |
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