Advance Directives

The laws of Louisiana uphold the fundamental rights of all persons to control the decisions relating to their own medical care, including the use of life-sustaining procedures. This patient right is respected through the Declaration Concerning Life-Sustaining Procedures document, best known as a Living Will.

Advance directives are a way for you to decide in advance the type of medical care you want if you become unable to make that decision later. Put advance directives in writing now, while you are well, and share your decision with anyone who may need to be notified.

State and federal laws require hospitals to give you information about advance directives. We must also tell you our policy for carrying out your advance directive. If you need more information, please ask one of our team members to help you.

There are Two Types of Advance Directives:

Living Wills

Living Wills are written instructions that explain your wishes for health care if you are dying or are in an irreversible coma or unable to state your wishes.

Durable Power of Attorney for Health Care

Durable Power of Attorney for Health Care is a document that lets you name a person to make medical decisions for you if you become unable to do so. Sometimes this is also called a "health care proxy."

Who Can Have an Advance Directive?

As an adult you can, at any time, write wishes and instructions for your doctor. However, the following guidelines are important:

• You must sign the written statement in front of two witnesses. The witnesses must also sign.
• The witnesses must be competent adults who are not entitled to any part of your estate at the time of your death.

A person can make an oral or nonverbal declaration in the presence of two witnesses (as described above) only after being diagnosed with a terminal condition.

Responsibility to Inform the Doctor

You are responsible for letting your doctor know that you have an advance directive. If you become mentally or physically unable to communicate, any other person may let the doctor know about your advance directive. It is a good idea to give your doctor a copy of your advance directive and to provide a copy whenever you are admitted to the hospital.

Does an Advance Directive Affect Insurance?

NO. Louisiana law supports this. An advance directive cannot affect your ability to receive life insurance or change the terms of any insurance policy, regardless of what the policy may say. The law also states that if life support is removed, according to your advance directive, death cannot and will not be considered suicide.

Can an Advance Directive Be Cancelled?

YES. Louisiana law provides that an advance directive can be taken back or cancelled at any time by the person who made it without regard to mental state or competency. Your advance directive can be cancelled by any of the following methods:

• By being cancelled, defaced, damaged, burned, torn, or otherwise destroyed by you or someone else in front of you and at your direction.
• By writing a statement that cancels the original decision and signing it, with the date listed.
• By speaking your wishes or indicating them by unspoken gestures.

NOTE: Your advance directive is still active and not considered cancelled until the attending doctor is informed.

Before Making Decisions

Before making any decisions, we urge you to talk to your doctor, lawyer, clergy, and family. Our staff can tell you how to reach our chaplain or social workers.

Different states have different laws regarding advance directives. You should have a living will for the state in which you are hospitalized. Although a written indication of your wishes is helpful, healthcare workers are often reluctant to follow them if they don't comply with their state laws. If you spend time in another state, check with your attorney to see if you need to create a modified version of your living will for that state.

Can Anyone Else Make an Advance Directive for Me?

If an adult has not made an advance directive, the law gives the following persons the right to make it for them:

• Any person chosen by the patient.
• The court-appointed guardian of the patient.
• The patient's husband or wife, provided they are not legally separated.
• The patient's adult children, together.
• The patient's parents, together.
• The patient's brothers and sisters, together.
• The patient's other relatives, together.
• The statement, "together," means that the decision must be unanimous, or agreed upon, by everyone in the group that is reasonably available for consultation, AND, at least two witnesses, as described previously, must be present at the time the decision is made.

What About a Minor?

If a minor child (under the age of 18) is diagnosed with a terminal illness or condition with little hope of recovery, the following persons may decide about life support measures:

• The patient's husband or wife, if older than 18.
• If there is no husband or wife, if the husband or wife is not available, or if the husband or wife is under the age of 18, either the parent or guardian of the patient may make decisions about life support measures.

This type of advance directive must be signed by the person making the decisions in front of two witnesses, as described previously. The witnesses must also sign.

However, a person cannot "speak" for the minor if he or she has information from the patient that contradicts the decision.

A person cannot "speak" for the minor if, as a parent or guardian, he or she knows that the other parent or guardian or spouse (of legal age) disagrees.

Special Directions

• Keep a card in your wallet stating that you have an advance directive and where to find it.
• Give your doctor a copy.
• If you use a durable power of attorney, give your proxy a copy too.
• Discuss your advance directive with your family and friends or anyone who might be called in an emergency.
• Review your advance directive regularly; make changes as necessary.
• You may add information to your living will in the area above your signature. For example: "If any of my tissues or organs are sound and would be of value as transplants to other people, I freely give my permission for such donations."
• Be sure to give copies of any changes to your doctor, family, proxy, or anyone else who might be called in an emergency.
• Take a copy with you to the hospital whenever you think you will be admitted.

You may register your declaration with the Office of the Secretary of State. However, you are not obligated to do this. To register your declaration, you should send a certified copy or the original declaration itself to:

Office of the Secretary of State
P.O. Box 94125
Baton Rouge, LA 70804-9125

The Secretary of State currently charges a fee for registration. If you have any questions you may call the Office of the Secretary of State. The phone number is (225)342-4980.

Organ and Tissue Donation

Thousands of Americans, many of them children, are awaiting the donation of organs, which will mean life-saving transplantation for them. However, hundreds of organs and tissues are wasted each year. This is because most families find it hard to make decisions to donate at the time of their loved one's death, if they have not talked about it before.

By discussing organ and tissue donation now, you can let your family know your feelings. You can sign a donor card, or the back of your driver's license. With this decision, you can help someone fight terminal or debilitating illness with organ and tissue donation.

What is a Uniform Donor Card?

The Uniform Donor Card is a legal document through which you express your wish to donate organs for transplant.

How do I use this card?

After you have completed the card to show your wishes, you should sign it, have it witnessed, and carry it with you. You should also tell your spouse, immediate family, friends and physicians of your wish to be an organ donor.

What if I change my mind?

If you change your mind, simply tear up your donor card. You can always get a new one if you change your mind again.

How do you get organs for transplant?

They are donated by individuals at the time of death. The circumstance(s) of death, medical criteria, and age of the donor determine which organs can be used.

Is there religious support for organ donation?

All major religions in the United States officially support the humanitarian value of organ procurement as the ultimate act of caring for our fellow man. Your own minister, priest, or rabbi is the best person to guide you in this consideration.

Durable Power of Attorney for Health Care

What is Durable Power of Attorney for Health Care?

Durable Power of Attorney for Health Care is a document which gives the person you name as your agent the authority to make any and all health care decisions for you if you cannot make them for yourself.

Who can be appointed my agent?

The person you appoint should be someone you know and trust. He/she must be 18 years of age or older. You should tell the person you appoint that you want him/her to be your agent.

Can my health or residential provider be my agent?

If you appoint your health or residential care provider (such as your physician, an employee of a home health agency, hospital, nursing home, or residential care home), that person has to choose between acting as your agent or as your health care provider. This person cannot be both.

When does my agent's authority begin?

You have the right to make healthcare decisions for yourself as long as you are able to do so, even after you have signed this document. Your agent's authority begins when your physician certifies that you cannot make health care decisions.

How long is the document effective?

The Durable Power of Attorney for Health Care is effective until you cancel it. You have the right to cancel the authority granted to your agent by telling your agent or your health care or residential care provider orally or in writing. You may also make out a new document.

Who may witness?

Your best witnesses are close friends. Witnesses cannot be your agent, health or residential care provider, an employee of your residential or health care provider, your spouse, your lawful heirs or beneficiaries, creditors or persons who have claims against you. If you have no witnesses available, you may contact the hospital's Social Services Department or Chaplain.

Where should this document be kept?

You should give your agent and your physician a signed copy of this document. You should indicate on the document itself the people and institutions who have signed copies.

Additional Information on Advance Directives

For additional information on Advance Directives try searching the web with these key words: advance directives, dying, living wills, or organ procurement.