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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:

 

  1. 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.
  2. 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.
  3. 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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