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Advanced Directives

Making Your Wishes Known

Also known as living wills, advance directives outline predetermined actions that should be taken in regards to your health if you are no longer able to make decisions for yourself due to incapacity or illness. These legally binding documents outline your wishes regarding life support, resuscitation and other interventions for both your health care team and your family members.

About Advance Directives

There are two different types of directives: A Living Will and a Designation of Health Care Surrogate Form, which is sometimes known as a Durable Power of Attorney for Health care. Both can be changed anytime, and you’ll want to update them periodically.

Living Will: Provides your physician instructions regarding procedures that are meant to prolong your life. Your physician and your health care surrogate are required to follow all the directives in a Living Will.

Designation of Healthcare Surrogate: Allows you to appoint another adult to make decisions on your behalf when you are unable to do so. It is usually recommended that you appoint someone who knows your wishes and is willing to carry them out, especially regarding your personal, religious, moral and cultural beliefs. If you are incapacitated, your health care surrogate will have the authority to make all the medical decisions regarding your health care, including decisions about when to withhold or withdraw life prolonging procedures.

If you establish Advance Directives, make sure members of your immediate family know about them and where they are located. You’ll also want to share a copy with your primary care physician to include as part of your medical records, and them provide a new copy if your directives change. Be sure to also bring a copy with you when you’re admitted to the hospital.

FAQs About Advance Directives

On what laws are Advance Directives based?
Two main statutes guide the Advance Directives. At the federal level there is the Patient Self-Determination Act and at the state level, Florida’s Health Care Advance Directive Act (Florida Statute Chapter 765). These statutes outline the guidelines for directives.

Why is it important for me to complete Advance Directives?
There may be times whether because of an accident, injury or illness, you may not be able to make sound decisions about your health care. However, decisions still need to be made regarding your treatment and care; directives outline who can legally speak on your behalf and see that your wishes are carried out.

Who can complete a directive?
Any person who is 18-years of age and older, as well an emancipated minor, can have Advance Directives.

When are they valid?
You will need two witnesses present when you sign your directives. Only one can be a spouse, family member or relative; your health care surrogate cannot be a witness. These documents do not need to be notarized to be legal, though some prefer to have them notarized along with any other legal documents, such as a will.

When do Advance Directives take effect in a hospital?
The Designation of Health Care Surrogate takes effect as soon as your physician deems that you are unable to make your own health care decisions. A Living Will be will be enacted only when your attending physician along with a consulting physician determine you are:

1) Unable to make your own medical decisions and are unlikely to regain this ability.

AND

2) In a terminal persistent vegetative state, an end-stage condition, or in any other condition that you specified in your Living Will. A more complete definition of applicable conditions can be found in the instructions section of the Advance Directives form available for download above.

How long are Advance Directives valid?
These documents are valid indefinitely, unless you have specified an expiration date on the document. They become void at the time of your death or when you have rescinded them or declared them void.

If I did not designate a health care surrogate or have a court appointed guardian, who would make the decisions on my behalf if I was in the hospital and unable to make them myself?
According to Florida law, the following individuals would make these decisions. They are, in the order of priority:

  1. Spouse (Florida law does not recognize common law marriages as a legal marriage contract).
  2. Adult children who are reasonably available for consultation (in person or by phone).
  3. Parent(s).
  4. Sibling(s) who are reasonably available for consultation (in person or by phone). Being the oldest child does not give that child any higher priority.
  5. Relative who has exhibited special care and concern for the patient and who has maintained regular contact with the patient and who is familiar with the patient's activities, health and religious or moral beliefs.
  6. Close Personal Friend - to qualify, the friend shall be 18 years of age or older, have exhibited special care and concern for the patient; has signed a Close Personal Friend affidavit stating he or she is a friend of the patient; and is willing and able to become involved in the patient's healthcare and has maintained regular contact with the patient so as to be familiar with the patient's activities, health and religious or moral beliefs.

When should a person make sure that a Designated Health Care Surrogate has been appointed?
Prior to your medical procedure you should appoint a designated health care surrogate. If you already have one designated, changes in marital status or within your family may require changes to your surrogate appointment as well:

  • Single
  • Newly Married
  • Divorced, or contemplating divorce
  • Separated
  • Living with a significant other
  • Wanting to designate one person from the proxy category where there are several people.

When I am admitted as a patient to Florida Hospital, will I be asked about Advance Directives?
Yes, if you are an adult or emancipated minor inpatient. When you are admitted to a nursing unit you will be asked to complete a personal health history form or your nurse will assist you. At this time you will be asked about an Advance Directives form that has a summary of Florida Hospital’s policy.
If you have completed Advance Directives, please bring a copy with you to the hospital and give it to your nurse. If you would like to complete one, please let your nurse know. If you have questions after reading the instructions on the back of the Advance Directives form, you may request to speak to a chaplain, case manager or your physician.

Does a Living Will mean the person is not to be resuscitated in the event of a cardiac and/or respiratory arrest?
No, but if you do not wish to be resuscitated in the event of cardiac or respiratory arrest, you must discuss this with the attending physician so that a Do Not Resuscitate (DNR) order can be entered into your medical records. This form must be completed by you and your physician in order to be valid and take effect.