Living Will: Questions & Answers

You Have a Choice
With the enactment of the  Texas Advance Directives Act, you now have the option to decide for yourself whether you would want artificial life-sustaining procedures used should you develop a terminal condition where death is imminent or is expected to result within six months without application of life-sustaining procedures, or should you develop an irreversible condition that is fatal without the application of life-sustaining procedures. Signing a  Directive to Physicians, also called an Advance Medical Directive or  Living Will, while you are of sound mind allows you to remain in control of this important decision and relieve family members of this burden of responsibility at a time when decisions of this magnitude would be very difficult to make.

Read through the following questions and information carefully, making note of any additional questions you may have. The  Advance Medical Directive  form, which can be obtained from a Hillcrest chaplain, is taken directly from the Texas  Advance Directives Act,  and if properly filled out, is legally binding. It can also be revoked at any time. If you have further questions, please contact the Hillcrest Baptist Medical Center Department of Pastoral Care at (254) 202-9530.

What is an Advance Medical Directive?
An  Advance Medical Directive is a legal document that directs your physician to administer or not to administer artificial life-sustaining procedures if you have a terminal or irreversible condition.  A terminal condition means an incurable condition caused by injury, disease, or illness, that without the use of life-sustaining procedures would, within reasonable medical judgment, produce death within six months, and where the use of life-sustaining procedures serves only to postpone the moment of death. An  irreversible condition means a condition, injury, or illness that cannot be cured or eliminated, leaves a person unable to care for or make decisions for themselves, and without the use of life-sustaining procedures is fatal. Treatment according to your instruction in an  Advance Medical Directive takes effect when, in the judgment of your physician, you are suffering from one of these conditions.

Who Can Sign an Advance Medical Directive?
A person who is at least 18 years of age and of sound mind may sign an  Advance Medical Directive  as provided by the Texas  Advance Directives Act. The Act also enables certain persons to execute an  Advance Medical Directive  on behalf of individuals who are not able to execute a directive themselves. If you are in a situation in which another individual cannot personally execute a directive, please contact the Hillcrest Baptist Medical Center Department of Pastoral Care.

Does an Advance Medical Directive Have to be Notarized or Witnessed?
To be effective, an  Advance Medical Directive must be signed by you and witnessed by two other persons. Notarization is not required. The first of the two witnesses cannot be:

Any person designated to make a treatment decision for you;

• Any person related to you by blood or marriage;
• Any person entitled to any part of your estate or who may have a claim against any part of your estate;
• Your attending physician or that physician's employee;
• If a health care facility is providing care for you, any employee of that facility involved in providing direct patient care and any officer, director, partner, or business office employee of that facility or its parent organization
  

To Whom Should I Give Copies of My Advance Medical Directive?
You should give a copy of your  Advance Medical Directive to your primary physician and to significant members of your family, including all of your children. It is suggested that you have a copy of your  Advance Medical Directive with you anytime you are hospitalized. Photocopies of your  Advance Medical Directive do not have to be notarized. Don't forget to keep a copy for your records.

Can an Advance Medical Directive be Revoked?
Yes, an  Advance Medical Directive can be revoked at any time. Your revocation may be done either orally or in writing. Remember, it is your responsibility to communicate your decision to significant family memebers, as well as to your primary physician and any other health care providers that have copies of your  Advance Medical Directive.

Can I Sign an Advance Medical Directive When a Terminal or Irreversible Condition is Diagnosed?
Yes, if you are of sound mind. However, it is best to make this decision before faced with the emotional effects of a terminal illness. Again, signing your  Advance Medical Directive while you are of sound mind, allows you to make the decision for yourself and relieves your family of this responsibility.

Does an Advance Medical Directive Affect My Regular Medical Treatment?
No, an  Advance Medical Directive only affects your medical treatment if in the judgment of your attending physician you are suffering from a terminal or irreversible condition and you have requested that all treatments other than those needed to keep you comfortable be discontinued. Until that time, all regular medical care will be administered. Even after you are suffering from a terminal or irreversible condition, procedures that provide comfort, care, or alleviation of pain will be administered.

What Kinds of Treatment can be Withdrawn or Withheld from Me?
The  Advance Medical Directive is a directive to your physician not to use or to use artificial methods to extend the natural process of dying. Generally, procedures involving mechanical devices that artificially extend your body functions, such as breathing devices and electrical devices that alter your heart rhythm or restart your heart are included. In each situation, your treating physician would decide what devices to withhold or withdraw. You may also direct whether you do or do not want artificial nutrition and fluids to be used.

Can I Designate Someone Else to Make Health Care Decisions for me?
Yes, if you do not have a  Medical Power of Attorney. When you execute an  Advance Medical Directive you may designate a person(s) to make treatment decisions for you if you become unable to make your wishes known.

The preceding information is provided as a courtesy of Hillcrest Baptist Medical Center. It is offered for informational purposes only and is not intended as a recommendation for or against enactment.