Advance Directives (Living Wills)
It can be difficult for doctors and loved ones to know what kind of treatment you want if you are unable to tell them. The best way to make sure your wishes are respected is to discuss them with your health care provider and your loved ones while you’re healthy and then fill out an Advance Directive form. We hope you will consider filling one out.
What is an Advance Directive?
An Advance Directive is a way to protect your right to choose or refuse medical treatment. Alabama law allows you, as an adult, to give instructions to your doctors before you become too ill to make your own decisions. The UAB Health System has both inpatient and outpatient facilities that can provide Advance Directive information to you. Federal laws states that when you are admitted to a hospital, you must be asked if you have or want to complete an Advance Directive, even though you may not have a chronic or terminal illness. The hospital may accept an Advance Directive written in another stat if it meets the Alabama requirement.
There are two types of Advance Directives – a living will and a durable power of attorney for health care. You may also appoint a health care proxy in your living will. Each type of Advance Directive is explained in this handbook. If you need a living will or organ donation form, they can be provided for you.
Am I required to have an Advance Directive?
You do not have to have an Advance Directive. The UAB Health System is committed to preserving life and easing pain and suffering for every patient under our care. We will provide medical and nursing care to prevent pain and suffering and to provide comfort no matter what choice you make about cardiopulmonary resuscitation (CPR) or other treatment.
We will provide medically necessary and appropriate treatment, including CPR, unless a decision not to perform CPR has already been made or you have a living will that states you don’t want such treatment. CPR is an attempt to restart your heart or breathing if it stops. You doctor is responsible for telling you about your health problems and how treatment will or won’t help so you can make a choice about CPR and other treatment.
Why does it help to have an Advance Directive?
An Advance Directive helps your doctor know what you would choose in times of:
- Terminal illness – where death is expected to occur within six months despite all medical treatment, or where life is impossible unless we use a treatment like a breathing machine, such as a ventilator; or
- Permanent unconsciousness – a condition expected to last permanently without improvement, where you are unable to think, feel, move, or interact with others, and where you are not aware of yourself or your surroundings.
What kinds of choices have to be made?
New medication, treatments and equipment save many lives, but may lives, but may also prolong lives where there is little chance of recovery. If you were terminally ill or permanently unconscious, consider the following questions:
- Would you want the doctors to do everything they can for as long can they can?
- Do you want the doctors to try to restart your heart and breathing if it stops?
If you haven’t put your wishes in an Advance Directive, doctors will talk with your family or proxy to make choices about your treatment if you are too sick to choose for yourself.
Who can help me make these choices?
It’s normal to feel anxious and uneasy about making these choices. Choose someone with whom you feel comfortable to discuss the kind of life you want in the event of terminal illness or permanent unconsciousness. Your doctor, nurse, chaplain or pastor, medical social worker, or patient representative is available to assist you. You may want to complete an Advance Directive while you are in good health, so you have time to think about what choices to include in your living will.
What is living will?
A living will lets you put into writing which medical treatments you do and do not want at the end of your life. It takes effect only when you are not able to let your doctors know your wishes.
It applies only when you have a terminal illness where death is expected within six months and when further treatment will not save your life or when you are in a state of permanent unconsciousness and improvement is not expected. You need to talk to your doctor about your health so you will know what may happen following treatment.