Making Healthcare Decisions

Informed Consent Policy

Altru Hospital’s Informed Consent policy states that you, as a patient, have the right to make choices regarding your own healthcare, and further, that you have the right to the information you need in order to make informed choices.

Your Right to Make Your Medical Decisions

As a competent adult, you have the right to control decisions about your own healthcare. You have the right to accept or to refuse any treatment, service or procedure used to diagnose, treat or care for your physical or mental condition.

You have the right to make your own healthcare decisions as long as you have the ability to understand:
 

1. your medical condition and
2. the benefits, risks and burdens of a particular course of treatment and care and its alternatives.

Your right to decide also gives you the right to control the use of medical technology in regard to your healthcare. The concept of living longer by using medical technology is complex. Part of your right to make your own medical decisions is your right to decide, based upon your values, the extent to which medical technology should be used and under what circumstances.

Your right to decide also includes the right to make decisions regarding the artificial giving of food and water (nutrition and hydration).

To Exercise Your Right To Make Your Own Medical Decisions, You Should Do The Following:
 

1. Make certain you understand your medical treatment options. If you do not understand something or need more information, ask your healthcare providers. You have the right to an explanation in terms that you actually understand.
2. If you have ethical or moral concerns about your decisions, you should speak to your minister, rabbi, priest, or other advisor, perhaps a member of your family or a close friend. Assistance in making treatment decisions is available at Altru Hospital. The Spiritual Care staff, the social work staff and the nursing staff are ready to support you with the emotional, spiritual, moral, and ethical concerns that accompany such decisions.
3. They can be contacted as follows:
   1. Nurse: Press your call button
   2. Spritual Care: 780.5300
   3. Social Work: 780.5345
   4. Palliative Care: 780.5442

Discuss your desires with your physician or healthcare provider. Make sure that your healthcare provider understands what you want in the event you are unable to make your own medical decisions.

There may come a time when, due to your mental or physical condition, you may be unable to make your own healthcare decisions. Then your healthcare providers will look to any prior written advance directive or to family members to make decisions on your behalf. A determination that you are unable to make your own healthcare decisions must be made by a physician.

Two forms of advance directives have been approved by the North Dakota legislature: a Living Will and a Durable Power of Attorney for healthcare. In addition, North Dakota also has an Informed Healthcare Consent Law which authorizes other persons to make health care decisions for you if you are either a minor or are unable to make your own medical decisions.

Informed Healthcare Consent Law

This law can be found in Section 23-12-13 of the North Dakota Century Code.

The Informed Healthcare Consent Law authorizes certain persons to provide consent for minors or persons who are incapacitated and, therefore, unable to make or communicate their own medical decisions.

This law prohibits consent for sterilization, abortion, psychosurgery, or admission to a mental health facility for more than 45 days without a court order. The law establishes a priority list of persons who are authorized to provide informed consent to healthcare on behalf of a minor or an incapacitated person.

The order of priority is as follows:
 

1. The individual, if any, to whom the patient has given a Durable Power of Attorney that encom passes the authority to make healthcare decisions, unless a court specifically authorizes a guardian to make medical decisions for the incapacitated person.
2. The appointed guardian or custodian of the patient, if any.
3. The person’s spouse, who has maintained significant contacts with the incapacitated person.
4. Children of the patient who are at least 18 years of age and who have maintained significant contacts with the incapacitated person.
5. Parents of the patient, including a step-parent, who has maintained significant contacts with the incapacitated person.
6. Adult brothers and sisters of the patient who have maintained significant contacts with the incapacitated person.
7. Grandparents of the patient who have maintained significant contacts with the incapacitated person.
8. Grandchildren of the patient who are at least 18 years of age and who have maintained significant contacts with the incapacitated person.
9. A close relative or friend of the patient who is at least 18 years of age and who has maintained significant contacts with the incapacitated person.

If you are an adult, the law requires that a physician determine that you are an incapacitated person before anyone is authorized to consent on your behalf. 

This law requires that a person who is authorized to provide informed consent on your behalf must first determine that you would have consented to the proposed healthcare if you were able. If such a determination cannot be made, the authorized person may consent only after determining that the proposed healthcare is in your best interest.

If you have not signed a durable power of attorney for healthcare, this law determines who can consent to your medical treatment if you become incapacitated or if you are a minor.