2(a). Alabama’s Advance Health Care Directive
Like the 1997 version, the 2001 version includes a living will
section and a health care proxy section. A competent adult can execute
either section alone, or both sections. The living will section
allows the individual to state whether, if two doctors, one of whom
is his/her treating physician, certify that (s)he is terminally
ill or permanently unconscious, (s)he would want life –sustaining
treatments. Although tube feeding is also a medical treatment, one
must make a separate statement about that.
A person may also appoint a “health care proxy” to make
decisions if (s)he becomes unable to speak for him/herself. The
person signing the document must state expressly whether the proxy
is to make decisions about tube feeding.
Although Alabama's Advance Directive is a good one, no document
that attempts to meet the demands of such a sensitive situation
can be perfect and a few problems have surfaced since its adoption:
- The Living Will section is only effective in situations in which
the patient is terminally ill or injured or permanently unconscious.
The drafters intended for the proxy appointment to be effective
in non-terminal as well as terminal situations. Some providers
do not interpret the document that way, and it is wise to add
language clarifying the declarant's intent about this.
- The proxy appointment allows the declarant, or person signing
the document, to specify certain people (s)he would like the physician
to talk with before removing life support. According to the statue
this does not permit those named to override the declarant's or
proxy's decisions, but sometimes those named (and also providers)
think it does. Some attorneys add a sentence or phrase clarifying
that point.
- Since adoption of the latest Advance Directive, federal privacy
regulations have become effective. There has been much confusions
about what health care providers must do to comply with these
regulations. Since the purpose of these documents is to avoid
controversy, it might be wise for attorneys to add a reference
to the HIPAA regulations in the document. The Advance Directive
and Health Care Power of Attorney forms on this site have sample
language. There is also a separate form HIPAA Authorization.
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