Advance Directives and Louisiana Law
Louisiana law recognizes that all persons have the right to control the decisions that relate to their own medical care. This control includes those decisions which an individual can make to have "life-sustaining procedures" maintained, withheld or withdrawn in the event the person is diagnosed as having a terminal and irreversible condition. In Louisiana, the way an individual makes such decisions and communicates these decisions to others is called a "Declaration". Each competent adult (18 years or older) has the right to make a Declaration. A Declaration is a written, oral or non-verbal communication which expresses the person's wishes regarding the maintaining, withholding or withdrawing of life-sustaining procedures in the event the person is diagnosed as having a terminal and irreversible condition. In other words, you can make a Declaration and instruct your physician, friends and family to maintain life-sustaining procedures and thereby maintain your life or you can instruct them to withhold or withdraw such procedures and allow you to die. You may also use a Declaration to designate another individual to make treatment decisions on your behalf in the event you are unable to do so. Because you may not be able to communicate your desires in the event you have a terminal and irreversible condition, the law allows you to make your Declaration before such unfortunate circumstances exist. Although it could include many things, basically a life-sustaining procedure is the kind of procedure (including the giving of food and water) which would only prolong the dying process. Such procedures do not include any measure which is necessary to provide comfort. A terminal and irreversible condition means:
- A continual "profound" comatose state with no reasonable chance of recovery, or
- A condition because of injury, disease or illness which will result in death and for which life-sustaining procedures would only postpone death.
If for any reason you do not make a Declaration, the law will not assume that you desire life-sustaining procedures. In fact, the law allows certain other people to make a Declaration for you if you are diagnosed as having a terminal and irreversible condition, unable to act on your own behalf and have not made a Declaration. Such a Declaration could authorize the withholding or withdrawing of life-sustaining procedures. Sometimes a Declaration or advance directive is referred to as a "living will". Louisiana law provides a suggested form, but it is only that. You are free to use your own words and you can make your instructions as specific as you desire. Here at Ochsner, we provide you with an additional resource: FIVE WISHES. This document provides you with a structure for thinking through your personal health care choices. Free copies may be obtained from the Information desk, Guest Services, Patient Relations, Pastoral Care, or your nurse. For assistance in completing FIVE WISHES, call (504) 842-9474 or (504) 842-wish. The form is not as important as the content of your Declaration that is, the law is more concerned with your desires and instructions than with the form of the Declaration. Your Declaration may be written or it may be made through any nonverbal communication. However, if you choose to make your Declaration, you must make it in the presence of two witnesses. Any adult person may act as a witness as long as that person is not related to you by blood or marriage and as long as that person is not entitled to inherit any portion of your estate. If you make a Declaration, you must notify your physician. It is your responsibility to take care of giving this information to your physician. In addition, you may register your Declaration with the Office of the Secretary of State. However, you are not obligated to do this. To register your Declaration you should send either a certified copy or the original Declaration itself to: Office of the Secretary of State P.O. Box 94125 Baton Rouge, LA 70804-9125 Attention: Publications The Secretary of State currently charges a fee for registration. If you have any questions, you may call the Office of the Secretary of State at 225-922-0309 or email@example.com. You may revoke a Declaration at any time. To revoke a Declaration, you may cancel, deface or destroy the Declaration. In writing, express your desire to revoke:
- Through verbal or non-verbal communication, express your desire to revoke
- File a written notice of revocation with the Secretary of State, in the event you registered your Declaration (a charge fee applies).
Another form of Declaration recognized by Louisiana is the "Durable Power of Attorney for Health Care Decisions". You may also use this to appoint someone to make health care decisions on your behalf, but you must expressly state that this is your wish and intent. Ideally, this should be done in the presence of a Notary Public, but it is not required. In order for a Durable Power of Attorney for Health Care Decisions to be used to withhold or withdraw life support, the authority to do so must be expressly given in the document. You have a right to make a complaint against a health care provider relative to advance directives requirements. Complaints regarding non-compliance by a hospital should be directed to the Department of Health and Hospitals, Health Standards Section toll free at 1-866-280-7737. The State of Louisiana, through the Department of Health and Hospitals, has developed this statement of your rights under Louisiana law. This is not meant to be legal advice, nor is it intended to take the place of the counsel, which can be provided by an attorney.
Advance Directives and Ochsner
Ochsner Health System respects your desire, as a patient, to direct your medical care and treatment. Ochsner Health System will honor all valid Living Wills and Durable Powers of Attorney for Health Care Decisions properly brought to the attention of an appropriate Ochsner representative. The honoring of such declarations shall be done in, and strictly in accordance with, state and federal laws governing such declarations. Ochsner will not discriminate on admission or provision of care based upon the execution of an advance directive. A situation might arise, however, when your advance directive will not be implemented due to the medical judgment or conscience of individual health care providers. In these cases, Ochsner Health System will attempt to resolve the disagreement or develop other options.
If you are an inpatient who wishes to file or revoke an advance directive in your medical record, contact your nurse or the Ochsner Medical Center, Admissions Department at 504-842-3210.
For Ochsner Medical Center - West Bank call 504-391-5151.
For Ochsner Medical Center - West Bank call 504-391-5126.
For Ochsner Medical Center - Baton Rouge call 225-761-5443.
For Ochsner Medical Center - Kenner call 504-464-8546.
Any questions you may have regarding the hospital policy on this issue can be directed to the Ochsner Medical Center, Patient Relations Department at 504-842-3971.