Publications and Guides

ADVANCE MEDICAL DIRECTIVES

What are Advance Medical Directives?
Advance Medical Directives are written instructions from you to your health care providers. These documents protect your right to control your medical care. By putting your wishes in writing ahead of time, you can maintain control of your medical care, even if you later become too ill to make decisions or to communicate with your health care providers.
 
There are two distinct types of advance directives recognized by Louisiana law. A Medical Power-of-Attorney allows you to name someone to make medical decisions for you. In a Living Will, you give specific instructions about the type of care you are to receive if you become very sick with a terminal illness.
 
 
Can't I leave all medical decisions to my doctors?
No. Except in a life-threatening emergency, medical personnel can not treat you without "informed consent". (This means that the health care provider must first explain the treatment to you, tell you of any risks, and then get your permission.) If you are unable to consent, and if there is no one legally authorized to consent for you, you may well go without treatment until the situation becomes life-threatening.
 
On the other hand, if you are likely to die without treatment, your health care provider will put you on life-support and keep you alive as long as possible. This is true even if you are in the final stages of a terminal illness and the treatment will only prolong your dying.
 
Life-support is only withheld if you or someone legally authorized to speak for you instructs your doctor to withhold it.
 
Moreover, the decisions about what treatment is appropriate for you depends in large part on your beliefs, values and desires. Your health care providers can tell you what treatment options are available to you, but often can not tell you which is best for you.
 

Do I need a Medical Power-of-Attorney?
This depends on your family situation. If you become unable to make decisions about your medical care, Louisiana law automatically gives your next-of-kin the right to make those decisions for you. (For the purpose of authorizing medical treatment, your next-of-kin is the first available person on the following list: a spouse, an adult child, a parent, a brother or sister, more remote relatives.)
 
If your next-of-kin knows and respects your wishes and if he or she will be available to consult with your health care providers, then you do not need a Medical Power-of-Attorney.
 
You should have a Medical Power-of Attorney if:

1. Your next-of-kin will be unavailable or unwilling to make medical decisions for you;

2. You do not trust your next-of-kin to carry out your wishes; or

3. You simply want someone other than your next-of-kin to make medical decisions for you.

Anyone you name in your Medical Power-of-Attorney must be at least 18 years old. Additionally, that person should live near you so he or she will be available to consult with your doctors, and should be someone who knows and will carry out your wishes.
 
 
What is a Living Will?
A Living Will is a document in which you place limitations on the type and extent of medical treatment you will receive at the end-stage of a fatal illness. It only applies when the following conditions have been met:

1. Two doctors have certified that you have an incurable illness which is likely to cause your death in the near future, regardless of the medical treatment you receive;

2. Without life-sustaining treatment your death is imminent; and

3. The life-sustaining treatment will not make you any better but will only prolong the dying process.

A Living Will is usually used to limit medical treatment under the above conditions, that is, to specify that you do not want to be put on a breathing machine, given cardiopulmonary resuscitation, etc. However, if you wish, you could leave instructions stating that you are to be given such treatments and kept alive as long as possible
 
 
Do I need a Living Will?
This also depends on your wishes and your situation. As with other medical decisions, if you have not already made decisions concerning life-support, the laws of Louisiana automatically give certain relatives the right to make those decisions for you. (Note, however, that only a very close relative, such as a spouse or parent, automatically has the legal authority to have life-support treatment withheld from you. A more distant relative, such as an aunt or a cousin, will not automatically have this authority, even if he or she is your next-of-kin and has the authority to make other medical decisions for you.)
 
You do not need a Living Will if your next-of-kin is a close relative whom you want to have make these decisions, and if he or she is comfortable with this responsibility.
 
You also have the option of naming someone else to make these decisions for you. Naming that person in a Medical Power-of-Attorney, however, is not enough: you must expressly state that he or she has the right to make decisions concerning life-support. Any document giving someone the authority to make decisions about like-support must have two witnesses.
 
You should have a living Will if you have wishes concerning like-support and if:

1. You have not designated anyone to make these decisions for you; and

2. Your next-of-kin is not a close relative, or

3. Your next-of-kin will be unavailable or unwilling to make these decisions, or

4. You do not trust your next-of-kin to respect your wishes, or

5. You simply do not want to burden anyone else with the responsibility of making these decisions.
    

Do I need to do anything else to protect my wishes?
Yes. You must let your health care providers know what you have decided. At a minimum you should give a copy of your Medical Power-of-Attorney and Living Will to any doctor or other health care provider whom you see on a routine basis.
 
If you have the opportunity, you should also discuss these documents with your health care providers. Many health care providers are not used to consulting someone who is not a family member. Thus, if the person named in your Medical Power-of-Attorney is not a relative, introduce him or her to your doctor and emphasize that he or she, rather than your relatives, will be making decisions about your medical care if you become unable to. The law authorizing living Wills is relatively new and many doctors are unfamiliar and/or uncomfortable with the withholding of life support. Thus you should also go over your Living Will with your doctor, emphasizing when you would want treatment withheld.
 

Can I change my mind after I sign the documents?
Yes. As long as you can communicate with your health care providers, they will go by what you tell them and not by what you have written in any documents. Also, you can revoke these documents at any time, simply by letting your health care providers know that you have changed your mind.
 

AIDSLaw SERVICES
AIDSLaw of Louisiana, Inc. provides free assistance with HIV-related legal problems.
 
This brochure is designed to provide general information. Although this brochure is prepared by professionals, it should not be used as a substitute for professional services. If legal or other professional advice is required, the services of a professional should be sought. AIDSLaw can provide legal assistance or referrals to persons needing services.
 
In addition to the medical decisions discussed in this booklet, HIV-infection makes it important for you to think about several other issues, such as confidentiality and discrimination, estate planning, child custody, and insurance and financial planning.
 
The AIDSLaw staff can provide you with additional information on these subjects and, when necessary, refer you to an HIV-sensitive and experienced attorney. If you are unable to afford an attorney, we will arrange for you to see one on a reduced or no cost basis.
 

AIDSLaw of Louisiana, Inc., is here to help with any HIV-related legal problem or need you may have.