If you establish one or more advanced directives, ask your physician to file it with your medical records. If you are unable to sign a written directive, you can issue a directive verbally, or by other means of non-written communication, in the presence of your physician. The directive goes into effect only after you have been diagnosed with a terminal or irreversible condition or are unable to communicate for yourself.
If you have not issued a directive and become unable to communicate after being diagnosed with a terminal or irreversible condition, your attending physician and legal guardian, or certain family members in the absence of a legal guardian, can make decisions concerning withdrawing, withholding or providing life-sustaining treatment. Your attending physician and another physician not involved in your care can also make decisions to withdraw or withhold life-sustaining treatment if you do not have a legal guardian and certain family members are not available.
Advance directives aren’t required, but if you choose to have one, either verbal or written, it must be witnessed by two individuals, one of whom cannot be a spouse or blood relative.
Types of Advance Directives
A Living Will
A living will is a written or verbal statement that declares what kind of medical care you do or don’t want if you become unable to make your own healthcare decisions. Terms of a living will might include instructions not to use life support machines or other artificial methods of prolonging life if you become terminally ill.
Health Care Surrogate Designation
A healthcare surrogate designation allows you to designate someone you trust to make healthcare decisions on your behalf in case you become unable to make these decisions on your own.
The person you designate must be an adult. You may choose a family member—such as your spouse, child, brother or sister—or a close friend. If you select your spouse and then become divorced, the appointment of your spouse as your agent is revoked.
The following people cannot be appointed as your agent:
- Your current healthcare provider
- An employee of your healthcare provider, unless he or she is related to you
- Your residential care provider or an employee of your residential care provider, unless he or she is related to you
Your designated surrogate has authority to make healthcare decisions on your behalf only when your attending physician certifies that you lack the capacity to make your own healthcare decisions. Your agent must make healthcare decisions after consulting with your attending physician and according to your wishes, including your religious and moral beliefs. These decisions can include authorizing, refusing or withdrawing treatment, even if it means you will die. If your wishes are unknown, your agent must make a decision based on what he or she believes is in your best interest.
As an alternative to a healthcare surrogate, you can designate a durable power of attorney (POA). While similar to a healthcare surrogate, the person designated in your POA can perform a variety of functions, such as making medical, financial and legal decisions.
An anatomical donation indicates your wish to donate all or parts of your body upon your death. This donation can be organ and tissue donation to other people in critical medical need, or you can donate your body to medical research or healthcare training facilities. You may indicate your decision to be an organ donor on your driver’s license or other state ID card, by filling out a donor form, or by writing such instructions in your living will.
More Information of Advance Directives
Pre-hospital Do Not Resuscitate Order (DNR)
A pre-hospital do not resuscitate order (DNR) states that you do not wish to be revived in the case of respiratory or cardiac arrest. This form is a specific yellow form provided by the Florida Department of Health and must be signed by you or a legal representative and your physician.
IMPORTANT: To be legally valid this form MUST be printed on yellow legal paper prior to being completed. EMS and medical personnel are only required to honor the form if it is printed on yellow legal paper.
An advance directive does not need to be notarized. Neither this hospital nor your physician may require you to execute an advance directive as a condition for admittance or receiving treatment in this or any other hospital. The fact that you have executed an advance directive will not affect any insurance coverage that you may have.
Patients and families may participate in ethical questions that arise in the course of care, including issues of conflict resolution. North Shore Medical Center has a formal process in place to address ethical issues and dilemmas involved in your care. Should you or your family desire an ethics consultation, please ask your nurse to contact the Hospital Ethics Consultation Team.