Advance Directives

Many people are concerned about the medical care they will receive if they become terminally ill and unable to communicate. Medical care today has the ability to provide treatments and procedures that are capable of prolonging life and postponing the death of someone who is terminally ill. Some people do not want to spend months or years dependent on life-support machines, and they do not want to cause unnecessary emotional or financial distress for their loved ones. This is why a growing number of people are taking action before they become seriously ill. They are stating their healthcare wishes in writing, while they are still healthy and able to make these decisions, through legal documents called Advance Directives. 

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Commonly asked questions about Advance Directives

What are Advance Directives?
Advance Directives are documents written in advance of a serious illness that state your choices for healthcare and/or to name someone to make decisions for you if you become unable to make them. There are two types of Advance Directives: a Declaration Concerning Life-Sustaining Procedures (also known as a Living Will) and Power Of Attorney for Healthcare. 

What is a Declaration Concerning Life-Sustaining Procedures?
A Declaration Concerning Life-Sustaining Procedures (Declaration) is a written document indicating the care you want including withholding or withdrawing life-sustaining procedures in the event you should have a terminal and irreversible condition. This document must be signed and dated in front of two witnesses. 

Your Declaration should be discussed with your family and your doctor and be made a part of your medical record. Be sure to bring a copy of it with you every time you come to the hospital. Although you do not need a lawyer to prepare a Declaration, you may wish to discuss this with your lawyer.
What is a Power of Attorney for Healthcare? 
A Power of Attorney for Healthcare allows you to name another person to make medical decisions for you if you are unable or no longer wish to make them for yourself. Again, this document needs to be dated and signed in front of two witnesses. You can identify your Power of Attorney for Healthcare in the same document as your Declaration.
Your Declaration and Power of Attorney for Healthcare forms must be dated and signed in the front of two witnesses so the witnesses can confirm that:
  • you are the person who signed the document
  • you were not forced to sign it
  • you appeared to understand what you were doing.

Witnesses must be adults who are not related to the person making the declaration by blood or marriage and cannot receive any portion of the person's estate upon their death. The person you identify as your Power of Attorney for Healthcare cannot be a witness. At Our Lady of Witnesses must be adults who are not related to the person making the declaration by blood or marriage and cannot receive any portion of the person's estate upon their death. The person you identify as your Power of Attorney for Healthcare cannot be a witness. At Our Lady of Lourdes, hospital employees, your doctor and his/her employees cannot be witnesses.
What does the law say about this issue?
Since 1991, federal law requires that hospitals ask all patients 18 years and older, who are admitted to the hospital if they have a written Declaration or a Power of Attorney for Healthcare. In addition, federal law requires that hospitals, upon request, give patients information about their right to make decisions concerning medical care, the right to accept or refuse medical or surgical treatment, and the right to make Advance Directives. 

Laws differ somewhat from state to state, but in most cases a patient's expressed wishes will be honored. The laws of Louisiana have long recognized that all persons have the right to make decisions about their medical care. This includes the right to either consent to or refuse treatment and/or surgery. Informed consent means that you are fully informed of the reason and benefits of a treatment, any risks involved, and any options.
Louisiana law provides guidelines naming who can make decisions for you if you have not made your wishes known and have not authorized in writing someone to do so. The people in the following order have the right to make these decisions:
  1. Any person or persons previously designated by the patient, while an adult, in writing (Power of Attorney for Health Care).
  2. The court-appointed tutor or curator of the patient
  3. The patient's spouse not judicially separated*
  4. The patient's adult children
  5. The patient's parents
  6. The patient's brothers and sisters
  7. The patient's other relatives

If there is more than one person from number 4-7, then the Declaration shall be made by all persons of that group who are available for discussion upon good faith efforts.
Louisiana law defines "spouse" as a person who is legally married to the patient but does not include a spouse who:
  • Is judicially separated from the patient
  • Is living with another person in the manner of married persons
  • Has been convicted of any crime of violence against the other spouse that has resulted in the terminal and irreversible condition
  • Has violated any domestic abuse protective order affecting the other spouse

What will the hospital do to help if my family member or I should be in this situation?
Doctors, nurses, social workers, lawyers, and clergy are available to discuss issues, offer advice on hospital policy, and review cases. Often, they will provide options, however the final decision is up to you, your family, and the doctor.
How can I know in advance which procedures I would want or not want to prolong my life?
Although it is not possible to list every possible treatment, it is possible to decide what kind of treatment you would want in most cases. Your decisions can be made by thinking about and discussing with your family and others your views about dying. Think about how you feel about being totally dependent on others, the role of family finances, the conditions that would make life painful to you and how artificial life-support would affect the dying process. If you have questions about the kinds of treatments that are often used when illness is severe and recovery unlikely, ask your doctor. Regardless of your age, it is never too early to start this decision-making process, so do not wait.
What if I make a Declaration or Power of Attorney for Healthcare and then change my mind?
Any Advance Directive, including a Declaration or a Power of Attorney for Healthcare, may be canceled at any time by destroying it, by a written note, or even verbally.
What if I make an Advance Directive in one state and am hospitalized in Louisiana?
If you currently have a Declaration from another state, it probably will be legal in Louisiana. The forms provided by Louisiana law are samples of how to state your wishes. There are many other forms available. If you have any questions about a Declaration prepared in another state, you should contact your attorney and/or discuss it with your doctor.
Where should I keep my Advance Directive documents?
These documents should be kept in a safe yet accessible place. It is important that someone close to you knows where these documents are kept in case of an emergency. Your doctor and your family should have copies.
Will my healthcare providers honor my preferences as stated in my Declaration?
In most circumstances, healthcare providers will honor your preferences. Sometimes a healthcare provider may be hesitant to follow your wishes on moral or ethical grounds. If this happens, the provider will try to arrange for another provider who is comfortable with your wishes to care for you.
Does my religious tradition have anything to say about the Declaration or the kinds of medical treatment I should elect?
Most religious faiths allow individuals to make their own choices. If you have a question about Advance Directives from a religious perspective talk with your priest, minister, rabbi, imam or other representative of your religious group.