As a cancer patient, I worry that my wishes about medical care will not be carried out if I become unable to speak or think clearly. What can I do?

Patients have the right to make decisions about their own treatment. Sometimes a patient is unable to make these decisions, due to severe illness or a change in mental condition. That is why it is important for people with cancer to make their wishes known in advance.

A living will is a legal document containing a patient's instructions about medical care during the advanced stages of an illness. It is used only if the patient cannot communicate or make decisions. A living will protects the patient's rights and removes the burden for making decisions from family, friends, and doctors.

Every patient has the right to refuse or accept treatment. A decision to refuse "aggressive" medical treatment in the advanced stages of an illness is not the same as refusing all medical care. A patient can refuse aggressive treatment but still accept treatment for pain relief or comfort.

Patients also may name a health care proxy. This is a person who has agreed to make medical decisions if the patient cannot do so. A durable power of attorney for health care is the legal document that names a health care proxy. This document should be signed, dated, witnessed, notarized, and put into the patient's medical record. Copies should be given to the patient's doctor, hospital, and closest relative.

Even after a living will or durable power of attorney for health care has been signed, patients can change their mind at any time.

Patients who need help with these decisions should talk with their loved ones. They also can receive free professional help by calling Cancer Care, Inc. at 1-800-813-4673.

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