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If there comes a time when you are too sick to make your wishes known regarding your care, whom do you want to make decisions on your behalf? Have you put that decision in writing? [If yes, get copy of advance directive in question. If no, work with the patient to complete the appropriate advance directives.]
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Do you have any worries or concerns about a specific person trying to step in to make decisions for you?
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If yes, Have you discussed these concerns with that person? What about with your chosen health care surrogate/decision maker?
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Under the Hipaa Privacy Rule (45 CFR 164.510b), I can generally share information directly relevant to your care with your family and friends only if I have your permission to do so. What information, if any, would you like me to share with _______ regarding your illness, condition, or care?
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What information, if any, would you not want me to share with _______ regarding your illness, condition, or care?
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