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You have the right to make health care decisions that affect you

Advance Directives Brochure
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You have the right to make all decisions about the health care you receive. If you do not want certain treatments, you have the right to tell your doctor, either orally or in writing, you do not want them. If you want to refuse treatment, but you do not have someone to name as your agent, you can sign a living will.

Most patients can express their wishes to their doctor, but some who are badly injured, unconscious or very ill and cannot. People need to know your wishes about health care in case you become unable to speak effectively for yourself. You can express your wishes in an advance directive.

In a living will, you tell your doctor that you do not want to receive certain treatment. In a health care power of attorney, you name an agent who will tell the doctor what treatment should or should not be provided.

The decision to sign an advance directive is very personal and very important. This pamphlet answers some frequently asked questions.

These documents will be followed only if you are unable, due to illness or injury, to make decisions for yourself. While you are pregnant, however, these documents will not cause life support to be withheld.

If you do not have an advance directive that tells what you want done, you do not know what decisions will be made or who will make them. Decisions may be made by certain relatives designated by South Carolina law (Adult Health Care Consent Act), by a person appointed by the court, or by the court itself. The best way to make sure your wishes are followed is to state your wishes in an advance directive. If you want to refuse treatment but you do not have someone to name as your agent, you can sign a living will.

If you have questions about signing an advance directive, you should talk to your doctor, minister, priest, rabbi, or other religious professional. Finally, it is very important that you discuss your feelings about life support with your family.

A health care power of attorney also should be discussed with the people you intend to name as your agent and alternate agents to make sure that they are willing to serve and know your wishes.

Are there forms for living wills and health care powers of attorney in South Carolina?
Yes. The South Carolina legislature has approved forms for a living will and a health care power of attorney. The living will form that the legislature approved is called a Declaration of a Desire for a Natural Death. You may get these forms on-line or from your local:

Area Agency on Aging
Council on Aging
or
The Lieutenant Governor’s Office on Aging
1-800-868-9095 or 803-734-9900
Or 1-888-5wishes (594-7437)
The agent named in a health care power of attorney can make the decisions about your health care. A living will only tells the doctor what to do if you are permanently unconscious or if you are terminally ill and close to death. A health care power of attorney is not limited to these situations.

A living will affects life support only in certain circumstances. A living will only tells the doctor what to do if you are permanently unconscious or if you are terminally ill and close to death. A health care power of attorney is not limited to these situations.

Permanently unconscious means that you are in a persistent vegetative state in which your body functions, but your mind does not. This is different from a coma, because a person in a coma usually wakes up, but a permanently unconscious person does not.

A living will states what treatment you don't want. In a health care power of attorney you can say what treatment you do want, as well as what you do not want.

With a living will, you must decide what should be done in the future, without knowing exactly what the circumstances will be when the decision is put into effect. With a health care power of attorney, the agent can make decisions when the need arises, and will know what the circumstances are.

An Ombudsman as designated by the State Ombudsman, Office of the Lieutenant Governor, must be a witness if you sign a living will when you are in a hospital or nursing home. An Ombudsman does not have to be a witness if you sign a health care power of attorney in a hospital or nursing home. (From Death with Dignity Act, Section 44-77-40. This responsibility has been delegated to the Lt. Governor’s Office on Aging, Long Term Care Ombudsman Program.)

I want to be allowed to die a natural death and not be kept alive by medical treatment, heroic measures, or artificial means. How can I make sure this happens?

The best way to be sure you are allowed to die a natural death is to sign a health care power of attorney that states the circumstances in which you would not want treatment. In the South Carolina form, you should specify your wishes in items six (6) and seven (7).

Which documents should I sign if I want to be treated with all available life-sustaining procedures?

You should sign a Health Care Power of Attorney and not a living will. The South Carolina Health Care Power of Attorney form allows you to say either that you do or that you do not want life sustaining treatment. A living will only allows you to say that you do not want life sustaining procedures.

What if I have an old health care power of attorney or living will, or signed one in another state?

If you previously signed a living will or health care power of attorney, even in another state, it is probably valid. However, it may be a good idea to sign the most current forms. For example, the current South Carolina living will form covers artificial nutrition and hydration whereas older forms did not.

How is a health care power of attorney different from a durable power of attorney?

A health care power of attorney is a specific form of durable power of attorney that names an agent only to make health care decisions.
A durable power of attorney may or may not allow the agent to make health care decisions. It depends on what the document says. The agent may only be able to make decisions about property and financial matters.

What are the requirements for signing a living will?

You must be eighteen years old to sign a living will. Two persons must witness your signing the living will form. A notary public must also sign the living will form. If you sign a living will while you are a patient in a hospital or a resident in a nursing home, an Ombudsman witness must witness your signing.

There are certain people who cannot sign the document. Please read the living will form carefully to be sure your witnesses are qualified.

Who should I appoint as my agent? What if my agent cannot serve?

You should appoint a person you trust and who knows how you feel about health care. You also should name at least one alternate, who will make decisions if your agent is unable or unwilling to make these decisions. You should talk to the people you choose as your agent and alternate agents to be sure they are willing to serve.

Is there anything I need to know about completing the living will or health care power of attorney forms?

Each form contains spaces for you to state your wishes about things like whether you want life support and tube feeding. If you do not put your initials in either blank, tube feeding may be provided, depending upon your condition. Be sure to read the form carefully and follow the instructions.

Where should I keep my health care power of attorney or living will?

Keep the original in a safe place where your family members can get it. You also should give a copy to as many of the following people as your are comfortable with: your family members, your doctor, your lawyer, your minister or priest, or your agent. Do not put your only copy of these documents in your safe deposit box.
 
What if I change my mind after I have signed a living will or health care power of attorney?

You may revoke (cancel) your advance directive at any time. The forms contain instructions for doing so. You must tell your doctor and anyone else who has a copy, that you have changed your mind and you want to revoke your documents.