Area hospitals began educating patients about their right to make decisions in advance about medical care during life-threatening situations long before the federal government made doing so the law.
All of the half-dozen hospitals contacted yesterday in an informal survey had policies similar to the Patient Self-Determination Act of 1990, which requires hospitals to inform adult patients of their right to say in advance whether they want to be kept alive by artificial means.
But since the law took effect Sunday, those hospitals report stepping up efforts to provide their patients with information about how to write a living will or whom to name as a durable power of attorney if illness incapacitates them.
Franklin Square Hospital Center began disseminating packets informing patients of their rights regarding treatment in 1988 to meet the demands of an increasing number of geriatric patients, said Holly Duggan, a hospital spokeswoman.
"We were trying to get them used to the concept of pre-planning not only their funeral but what they wanted from the physician and hospital in terms of care," she said.
Hospitals like Johns Hopkins Medical Center and Sinai Hospital braced themselves yesterday for a flood of calls from patients, their relatives, private physicians and lawyers seeking in advance copies of the revised policy.
Harbor Hospital Center will sponsor a public seminar tomorrow to help its staff and patients talk about planning for death. Good Samaritan continues to dispense information through social workers and pastors, while the Greater Baltimore Medical Center plans by mid-January to include a copy of its policy in a hospital guest book for patients.
"Whatever the decision, these discussions have to be done carefully and thoughtfully," said Dr. W. Anthony Riley, a GBMC geriatrician who teaches doctors to prepare patients for the possibility of a disabling illness before hospitalizing them.
"I've had these discussions numerous times and one thing I've learned is that people are different. They change their minds," he said. "Some individuals feel comfortable making the decision that they want everything done, whenever and whatever it takes. . . . They want to see the birth of their grandchild or see their daughter married.
"There are others who have lived their lives a certain way and couldn't imagine being sustained on a feeding tube, ventilator or by some other measure."
Two public meetings are scheduled for tomorrow to inform people of their right to make medical treatment decisions when facing life or death crises.
The Patient Self-Determination Act, which became effective Sunday, calls for hospitals, nursing homes, HMOs, home health-care programs and hospices to inform patients of their right to refuse treatment or use of equipment that would prolong their lives.
The Maryland Conference of Social Concerns will hold a panel discussion and workshops from 8:45 a.m. to 4 p.m. at the F&G Life Building, 6225 Smith Ave. Speakers -- including lawyers, doctors, social workers and county and state officials -- will explore the ethical, legal and psycho-social issues that confront seriously ill patients. There is a $35 registration fee; $20 for people over 60.
Harbor Hospital Center is offering a free program at 10 a.m. Wednesday at the hospital, 3001 S. Hanover St. in Baltimore. The program will explain the types of documents a person can use to specify treatments at the end of a terminal illness if he is unable to speak for himself.
More information on the program may be obtained by calling the hospital's public relations office at (410) 347-3441.