Source: https://wearabledocs.com/help/documents/scope-choices [Help](https://wearabledocs.com/help)›[Your documents](https://wearabledocs.com/help#documents) # What choices do I make on each document? What each election means: state, apnea, vaccines with PEP, blood with fractions and autologous. Each document has its own page where you choose what it says. The choices are different for the two kinds of document. They refuse different things. ## Refusal of anatomical gift Open [Refusal of anatomical gift](https://app.wearabledocs.com/instruments/refusal-of-anatomical-gift) to set your choices. - **Organ, eye and tissue donation.** Ticked already, and required. It is what the document is: it refuses donation of your organs, eyes and tissue, and bars anyone else from authorizing it on your behalf. - **The brain apnea test.** Optional. The apnea test is how brain death is determined, and a determination of brain death is what allows donation to proceed. This choice is separate from the same one on the advance directive, so you may refuse it on one document and not the other. - **The state you sign it in.** Required. The blank cites that state's act by name, so it cannot be prepared without it. ## Advance directive (treatment refusal directive) Open [Advance directive](https://app.wearabledocs.com/instruments/advance-directive) to set your choices. What you refuse here is up to you; you can refuse one, two, or all three categories. A directive that refuses nothing cannot be printed. ### Vaccines Tick **Vaccines and immunizing agents** to refuse them, including any given under a standing order or a facility protocol without discussing it with you first. If you tick it, you must also answer: **does your vaccine refusal include prophylaxis after an exposure?** That is treatment given after a suspected exposure rather than as routine immunization: tetanus after a wound, rabies after an animal bite, hepatitis B after a needlestick. Rabies is very nearly always fatal once symptoms start, and prophylaxis is the whole of the treatment, so there is no default. The options are: | You choose | What it means | | --- | --- | | **Refuse prophylaxis too** | The refusal covers routine vaccines and post-exposure shots, and the document says you understand this can be fatal | | **Accept prophylaxis after an exposure** | The refusal covers routine immunization only. If a clinician determines you have been exposed, prophylaxis may be given | | **Something else, in my own words** | For refusing some prophylaxis and accepting other prophylaxis. Your sentence goes on the signed paper as you write it, and the document cannot print with this box empty | ### Blood Tick **Donor blood** to refuse transfusion of whole blood, red cells, white cells, platelets, and plasma, from any donor, under all circumstances. Two questions follow, and neither has a default: **Fractions.** Albumin, immunoglobulins, clotting factor concentrates, fibrin sealants, and other products made from donated blood. | You choose | What it means | | --- | --- | | **Refuse fractions too** | None of these may be given | | **Accept fractions** | These products may be given even though donor blood is refused | **Your own blood, recovered and returned.** No donor is involved. Cell salvage collects the blood you lose during an operation and gives it back; hemodilution takes some at the start and returns it at the end. | You choose | What it means | | --- | --- | | **Accept all of it** | Cell salvage, hemodilution, and blood you stored in advance for yourself. The document asks that they be used where they would help | | **Accept it only if it never leaves a circuit connected to me** | Cell salvage where the equipment stays in a continuous circuit with your body. Not blood that has been stored | | **Refuse it** | Nothing returned to you after it has left your body, including blood you donated in advance for your own use | The signed paper also states that refusing blood products is not a refusal of care, and asks for every other available treatment: measures to control bleeding, medicines that support your own blood production, and fluids. ### Brain apnea testing Tick this to refuse an apnea test in an evaluation for brain death, on this document. This is separate from the same choice on the refusal of anatomical gift; each document asks independently. ## What each refusal looks like on your page When someone scans your code, the record page shows each refusal under its own heading. Acceptances (fractions you accepted, prophylaxis you accepted) show in the same weight as the refusal above them, so a clinician reading at speed sees both what you refuse and what you allow. ## Related - [What documents can I create?](https://wearabledocs.com/help/documents/what-they-are) - [How do I print and sign?](https://wearabledocs.com/help/documents/print-and-sign) - [How do I upload?](https://wearabledocs.com/help/documents/upload) Open in the app [Advance directive](https://app.wearabledocs.com/instruments/advance-directive) [Refusal of anatomical gift](https://app.wearabledocs.com/instruments/refusal-of-anatomical-gift)