Advance Directive: A document in which a person either states choices for medical treatment or designates someone who should make treatment choices if the person should become unable to make decisions. Most often the term refers to formal, written documents, but it can also be used to include spoken statements by the patient.
Agent or attorney –in-fact: A competent adult who a person (the “principal”) can name in a Health Care Power of Attorney to make health care decisions for the principal.
Artificial Nutrition and Hydration: When you can’t eat or drink on your own, fluid and nutrients are delivered in an IV or through a tube in your stomach. (This is sometimes called a “PEG tube” –an abbreviation for “percutaneous endoscopic gastrostomy.”) Can be used short-term or long-term, depending on your needs and preferences.
Attending or Primary Physician: The doctor who has the main responsibility for your care while you are in the hospital. There may be other doctors (consulting physicians, resident doctors) caring for you as well as medical students.
Bioethicist: A professional specializing in dealing with ethical problems associated with medicine and healthcare.
Brain Death: It is a legal definition of death. Brain death is caused by a severe damage to the brain that cannot recover. Breathing has stopped, but the heart function continuous supported by artificial ventilation.
Breathing Tube (endotracheal tube): A temporary tube passed through the mouth and into the lungs. Air and oxygen is passed through the tube allowing for artificial breathing.
Cardiopulmonary arrest: When your heart and breathing has stopped.
CPR (Cardiopulmonary Resuscitation): An emergency procedure used if your heart or breathing stop, using external chest compressions, cardiac and respiratory equipment, and medications in an attempt to restart your breathing or heartbeat. CPR does not include clearing a person’s airway for a reason other than resuscitation.
Comfort Care: When curative care is no longer likely to help, medication or other non-invasive options are used solely to keep you comfortable. Health care professionals will be required to provide you with treatments to keep you comfortable, even if CPR is withheld. Comfort care is any action taken to promote patient comfort and diminish pain but not postpone death, such as administering pain medications, medications to treat shortness of breath, offering emotional support, etc.
Decision-Making Capacity: The ability to make choices that reflect an understanding and appreciation of the nature and consequences of one's actions.
Decisional Incapacity: When a patient is unable to understand his or her choices or speak his or her own wishes about his or her care.
Dialysis: An artificial means of cleansing the blood of waste products and removing fluids from the body when the patient's own kidneys are unable to continue this process.
Do Not Resuscitate (DNR): A Do Not Resuscitate (DNR) order indicates that a person will not receive cardiopulmonary resuscitation (CPR) in the event the heart or breathing stops. Basically, if the heart or breathing stops, the patient will die naturally. A DNR order is written by a physician or a Licensed Independent Practitioner after discussing the burdens and benefits of CPR with the patient or the patient’s surrogate decision maker.
Durable Power of Attorney for Healthcare: A written advance directive in which an individual names someone else (the "agent" or "proxy" or "attorney-in-fact) to make healthcare decisions in the event the individual becomes unable to make these decisions.
Ethics: A discipline concerned with making the correct or right decision about important aspects of our lives. Ethics is concerned with the identification and pursuit of values such as patient autonomy or patient welfare.
Ethics Committee: An interdisciplinary committee responsible for developing ethics and patient rights-related policies, and advising on patient care issues and institutional practices, as well as patient and health professional ethics education.
Futile Treatment: A useless therapy that does not benefit a patient in any way toward achieving the goal of improvement in health status or general condition.
Guardian: The person appointed by a court through a legal procedure to make decisions for a person (ward).
Health Care Power of Attorney: A legal document that lets the principal authorize an agent to make health care decisions for the principal in most health car e situations when the principal can no longer make such decisions. A health care power of attorney is not a financial power of attorney.
Hospice: A team approach that provides care for the terminally ill in the form of pain and symptom management, and emotional and spiritual support for patient and family, either at home or in a healthcare facility.
Hydration: Provision of fluids by any means to prevent dehydration.
IV (intravenous): Needles and tubing used to provide medication, hydration, nutrition, vitamins and electrolytes through a vein in the arm, hand or neck.
Intubation/Mechanical Ventilation: When you can’t breathe on your own, a breathing tube is placed in you through and into your lungs, connecting you to a machine that can breathe for you. Can be used short-term or long-term, depending on your needs and preferences.
Legal Guardian: A person charged (usually by court appointment) with the power and duty of taking care of and managing the property and rights of another person (adult or child) who is unable to take care of his/her own affairs.
Life-Sustaining Treatment: A medical treatment given to a patient that prolongs life and delays death.
Living Will: A written advance directive in which an individual states which healthcare decisions should be made if he or she becomes unable to make these decisions.
Medical Student: A student doctor in the third or fourth year of medical school training. The student doctor assists the primary and resident doctors in daily care of patients.
Ombudsman: A liaison between the patient and Cleveland Clinic. The staff of the Ombudsman's Office is available to patients and family members to help investigate and solve problems with medical service or care. The Ombudsmen report directly to key administrators and have the authority to investigate patient complaints.
Organ, Tissue and Eye Donation: A voluntary decision by the patient and/or family following the patient's wishes to provide access to the eyes, organs or other tissues after the patient has died.
Palliative Care: Medical treatments intended to control suffering and discomfort such as pain medication or treatment of an infection. These treatments will not cure the patient and are directed at managing the symptoms of the disease.
Palliative Medicine: A medical subspecialty that manages the symptoms as well as the psychological, social and spiritual problems associated with chronic progressive or terminal illnesses.
Patient Rights and Responsibilities: Statements describing a person's rights when receiving healthcare and his or her responsibilities as an active participant in that care.
Permanently Unconscious State: A condition of coma in which a patient is irreversibly unaware of himself and his environment, and has a total loss of higher brain functioning, resulting in no capacity to experience pain or suffering.
Persistent Vegetative State: Same as "permanently unconscious state."
Principal: A competent adult who signs a Health Care Power of Attorney.
Proxy: A person appointed to make decisions for someone else, as in a Durable Power of Attorney for Healthcare (also called a surrogate or agent).
Resident Physician: A doctor who works closely with the primary physician to manage a patient's daily care. The resident is a licensed medical school graduate doing further training in one of the specialties of medicine.
Terminal Condition: An irreversible, incurable and untreatable condition from which there can be no recovery. Nursing and medical efforts are administered to provide comfort.
TPN (total parenteral nutrition): A special intravenous (IV) solution providing hydration, vitamins, minerals and calories to sustain life. This IV is usually inserted into a large vein in the neck area.
Tube Feeding (enteral feeding): A temporary artificial method of providing food through a tube inserted into the stomach. This food is in a liquid form and contains calories, vitamins and electrolytes, and is used when food cannot be taken by mouth.
Ventilator: A machine used to assist or control breathing (may be called a respirator).
Ward: The person the court has determined to be incompetent. The ward’s person, financial estate, or both, is protected by a guardian the court appoints and oversees.