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What is an advance directive?

An advance directive is a way to legally protect your right to choose or refuse medical treatment, and it provides guidance to your doctors about what to do if you become terminally ill or permanently unconscious. Alabama law allows you, as an adult, to give instructions to your doctors before you become too ill to make your own decisions. UAB Medicine 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 state if it meets Alabama’s requirements.

There are two types of advance directives: a living will and a durable power of attorney for health care. A living will lets you put into writing which medical treatments you do and do not want at the end of your life, and 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 from which 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 also may appoint a health care proxy in your living will to make medical decisions on your behalf, which is similar to assigning durable power of attorney for health care to someone you trust. If you need a living will or organ donation form, they can be provided for you.

You are not required have to have an advance directive. UAB Medicine is committed to preserving life and easing pain and suffering for every patient under our care, 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 stating that you don’t want such treatment. 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 treatments. If you haven’t stated 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.

New medications, treatments, and equipment save many lives, but they also may prolong lives when there is little chance of recovery. Ask yourself the following questions before signing an advance directive:

  • Would you want the doctors to do everything they can for as long as they can?
  • Do you want the doctors to try to restart your heart and breathing if they stop?

It’s normal to feel anxious and uneasy about making these choices. Your doctor, nurse, chaplain or pastor, medical social worker, and patient representative are available to assist you. Choose someone you feel comfortable with to discuss the kind of life you want in the event of a terminal illness or permanent unconsciousness. 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.

Keywords: advance directive, terminal illness, power of attorney, living will

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