Introduction

Florida law grants every adult the right to make certain decisions about his or her medical treatment.* You have the right, under certain conditions, to decide whether to accept or reject medical treatment and other procedures that would prolong your life artificially. The law also ensures your rights and personal wishes are respected even if you are too sick to make your own decisions.

In Florida, there are three kinds of Advance Directive documents:

• Living Will
• Designated Health Care Surrogate
• Power of Attorney for Health Care

Another decision you can make in advance is organ donation.

*The legal basis for these rights can be found in the Florida Statutes: Life-Prolonging Procedure Act, Chapter 765; Durable Power of Attorney; Section 709.08; and Court Appointed Guardianship., Chapter 744; and in the Florida Supreme Court decision on the constitutional right of privacy, Guardianship of Estelle Browning, 1990.

Living wills

A Living Will (or Declaration) states that you do not want to be kept alive by medical treatment when you have a terminal or end-stage illness or are in a persistant vegetative state, and are no longer able to decide matters for yourself. The Living Will spells out your wishes regarding the withholding or withdrawing of life-prolonging measures when there can be no hope of recovery, as certified by two physicians. Medicines or medical procedures necessary to provide comfort or alleviate pain would continue to be provided.

The Living Will requires two witnesses, one of whom is not a spouse or blood relative.
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The health care surrogate

A designated Health Care Surrogate document is an Advance Directive which specifically allows you to name another person to make medical decisions for you anytime you become unable to make them yourself.

Your Surrogate may consult with health care providers and give informed consent to perform those medical and surgical procedures that he or she believes you would have agreed to under the circumstances.

The Health Care Surrogate requires two witnesses, one of whom is not a spouse or blood relative. The Surrogate may not serve as a witness.

The durable power of attorney for health care

This document is very similar to the Health Care Surrogate. It is usually written by an attorney and gives your decision-making power for your medical decisions to someone else. It can be specific as to what is covered, such as withholding or withdrawing life support, provision for food or water, etc. This document must be notarized and witnessed by two individuals, at least one of whom is not a spouse or blood relative.

Organ/tissue donation

You can request an organ donation card from TransLife - the organ recovery agency in Central Florida (call 676-1613 or 800-443-6667) - or any of the other 65 organ recovery agencies throughout the U.S. to document your wishes to make a gift of organs or tissue. You can also document your wishes on your Florida Drivers License. Organ/tissue donation is gift of life and is possible for people of all ages. All costs associated with organ/tissue donation are paid by the donor program, not by the donor's family. More information.

More about Advance Directives

Hospitals and nursing homes are now required to ask patients if they have any type of Advance Directive. You will need to bring your Advance Directive documents to the hospital with you for each admission.

You will be accepted for care whether or not you have an Advance Directive. Should you become incapable of making medical decisions during your hospitalization and you do not have a Surrogate, the hospital is required to find someone (a Proxy) to make decisions for you. The authority of the Proxy is not as broad as that of the Surrogate.

Upon admission to the hospital, after you reach your care area, your physician and nurse will confer and develop a plan to implement your Advance Directives during your hospital stay.

If you have any questions regarding Advance Directives, your physician, nurse, social worker, pastoral care, or Ethics Committee will be happy to assist you. Health First has forms for Living Wills and Healthcare Surrogates available on the nursing units.

It's a good idea to name a replacement in case your first choice becomes unwilling or unable to do so.

In summary

It's Health First's policy to honor patients' rights to make decisions about their medical care. This includes the right to accept or refuse medical or surgical treatment and the right to formulate Advance Directives.

Please keep the following in mind for all Advance Directives:

1. Discuss any Advance Directives with your physician, family, and friends as appropriate.
2. Bring your documents to the hospital for every admission.
3. You may change or revoke your Advance Directive(s); however, these changes do not go into effect until you communicate them to your healthcare provider.
4. Keep your Advance Directive(s) readily available (not in a safety deposit box) and make sure your family members know where they are. Give a copy to your physician, family, and/or friends who may be available to help.
5. Living Will and Designate Health Care Surrogate forms are available from Health First.
6. If at any time during your hospitalization, a hospital policy interferes with your written wishes, the situation will be discussed with you or your surrogate.
7. If you have any questions, do not hesitate to ask your physician, nurse, social worker, or call Health First's Department of Pastoral Care or Ethics Committee at 434-7183 (South Brevard) or 868-2718 (Central Brevard).