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Adult Patients with Medical Decision Making Capacity Who have Health Care Proxy (Any Setting) Mobile App

The Adult Patients with Medical Decision Making Capacity Who have Health Care Proxy (Any Setting) Checklist mobile app includes a 13 step checklist for medical decision making. A health care agent may make medical decisions on behalf of a patient, after two physicians concur that the patient lacks medical decision-making capacity. Health care agents are generally authorized to make decisions as if they were the patient. However, sometimes the patient’s health care proxy limits the authority of the health care agent. Health care agents are required to make decisions according to the patient’s wishes, including the patient’s religious and moral beliefs. If the patient’s wishes are not reasonably known and cannot with reasonable diligence be ascertained, the health care agent may make decisions according to the patient’s best interests, except a decision to withhold or withdraw artificial nutrition or hydration. Health care agents are authorized to make a decision to withhold or withdraw artificial nutrition or hydration only if they know the patient’s wishes regarding the administration of artificial nutrition and hydration. GoCanvas allows you to auto fill your app with information from a reference file.

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Take a peek inside the Adult Patients with Medical Decision Making Capacity Who have Health Care Proxy (Any Setting) Mobile App

Included Features

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Included Fields

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    Adult Patients Without Medical Decision-Making Capacity who Have a Health Care Proxy (Any Setting)

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    A health care agent may make medical decisions on behalf of a patient, after two physicians concu...

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    Health care agents are required to make decisions according to the patient’s wishes, including th...

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    Complete each step and check the appropriate lines as indicated.

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    Step 1: Assess health status and prognosis.

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    Step 2: Check all advance directives known to have been completed.

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    Health Care Proxy

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    Living Will

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    Organ Donation

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    Documentation of Oral Advance Directive

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    Step 3: If there is no health care proxy, assess capacity to complete a health care proxy.

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    Document the result of patient counseling, if applicable.

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    Patient retains the capacity to choose a health care agent and completes a health care proxy.

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    Patient retains the capacity to choose a health care agent, but chooses not to complete a health ...

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    Patient lacks capacity to choose a health care agent.

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    If there is no health care proxy, and patient chooses not to complete one or lacks capacity to do...

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    Step 4: Determine the patient’s medical decision-making capacity.

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    (A) Attending Physician Determination Check both:

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    The attending physician has determined in writing to a reasonable degree of medical certainty tha...

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    The determination contains the attending physician's opinion regarding the cause and nature of th...

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    (B) Assessment for Mental Illness or Developmental Disability and Concurring Physician Determinat...

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    (i) The attending physician has determined that the patient’s lack of medical decision-making cap...

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    A concurring physician confirmed that the patient lacks medical decision-making capacity.

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    (ii) The attending physician has determined that the lack of medical decision-making capacity is ...

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    A concurring physician confirmed that the patient lacks medical decision-making capacity.

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    One of the two physicians who determined that the patient lacks medical decision-making capacity ...

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    (iii) The attending physician has determined that the lack of medical decision-making capacity is...

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    A concurring physician or clinical psychologist confirmed that the patient lacks medical decision...

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