An advance directive for health care is a legal document which allows people to indicate their preferences for treatment and designate someone to make decision on their behalf if they are unable to do so.
Any person 18 years or older who has the capacity to make legal and/or medical decisions may complete an advance directive. “Capacity” means you are able to understand and appreciate the nature and consequences of health care decisions, including the benefits and disadvantages of such treatment, and to reach and communicate an informed decision regarding treatment.
No. No one; not even an insurer, physician, mental health treatment provider can force you to make an advance directive.
A health care representative is the person you appoint for the purpose of making health care decisions on your behalf when you are unable to do so. A health care representative can accept or refuse any treatment, service or procedure used to diagnose or treat my physical or mental condition, except as otherwise provided by law. A health care representative makes decisions on your behalf as stated in your advance directive. In the event your wishes are not clear or a situation arises that you did not anticipate, a health care representative may make a decision in your best interests, based upon what is known of your wishes.
Your health care representative can be a family member or a close friend whom you trust to make serious decisions. The person you name should clearly understand your wishes and be willing to accept the responsibility of making medical decisions for you. Your health care representative cannot be your attending physician; an operator, administrator or employee of a health care facility in which you are a resident, unless s/he is related to you by blood, marriage, or adoption.
Your advance directive for health care only goes into effect when your primary physician decides that you are unable to give informed consent. That means that your doctor believes you are incapacitated to the point where you can no longer actively take part in decisions for your own life, and are unable to direct your physician as to your own medical care. At any time after the appointment of a health care representative, the attending physician shall disclose such determination of incapacity, in writing, upon the request of the person named as the health care representative.
An advance directive allows you to state your preferences regarding any specific form of treatment, including electroshock (electroconvulsive therapy or ECT), a particular brand of medication, or any aspect of health care. Most of the time your stated preferences will be followed. Sometimes, the law allows your preferences to be overridden—like in emergencies—and, sometimes your preferences alone aren’t enough to make something happen. For instance, the fact that you prefer a certain medication doesn’t mean that a doctor must prescribe it. Also, the fact that you prefer a single room doesn’t mean your insurance coverage will pay for it.
There are legal requirements in completing an advance directive. The document should have your signature, the signature of two witnesses and a notary public, and the date the form was signed. In an inpatient setting, the client, the psychiatrist, and an attorney (or notary) are needed to execute an advance directive.
The requirements for changing an advance directive are the same as those for creating one. Your living will and wishes concerning any aspect of your health care, including the withholding or withdrawal of life support systems may be revoked at any time and in any manner without regard to your mental status. However, your appointment of a health care representative can only be revoked in writing, with your signature and the signature of two witnesses. Your revocation of your appointment of a health care representative does not, of itself, revoke your health care instructions.
Except as authorized by a court, a conservator shall comply with a ward’s individual health care instructions and other wishes, if any, expressed while the ward had capacity and to the extent known to the conservator. The conservator may not revoke the ward’s advance health care directive unless the probate court expressly so authorizes.
► An advance directive is a legal document through which you may provide directions as to your medical care. It is used when you are unable to make or communicate your decisions about your medical treatment. It is prepared before any condition or circumstance occurs that causes you to be unable to actively make a decision about your medical care.
► In Connecticut, judges and hearing officers have the power to override the treatment choices of some competent people and may therefore be able to override the choices you make, including medication choices.
► An advance directive for health care is meant to help you plan for the future. It is not meant to give legal advice. It does not try to answer all questions about anything that could come up. Every person is different, and every situation is different. Laws change from time to time. If you have a specific question or problem, talk to a medical or legal professional for advice.
You can locate forms available from the Connecticut Attorney General’s office here.
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Connecticut Legal Rights Project, Inc., (CLRP) is a statewide non-profit agency which provides legal services to low income individuals with mental health conditions, who reside in hospitals or the community, on matters related to their treatment, recovery, and civil rights.
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Connecticut Legal Rights Project, Inc.