Navigation
The Alabama Directive Health Care form is an essential tool for individuals wishing to communicate their medical treatment preferences in advance. This document allows people to outline their wishes regarding life-sustaining treatment, food, and hydration in the event they become unable to express their desires due to severe illness or injury. It consists of several sections, starting with a Living Will, where individuals can specify whether they want to receive life-sustaining treatment if diagnosed as terminally ill or permanently unconscious. Importantly, the form also addresses the provision of artificially administered food and hydration, giving individuals the opportunity to make their preferences clear. Additionally, the form allows for the appointment of a health care proxy—a trusted person designated to make medical decisions on one’s behalf if they are unable to do so. This section emphasizes the importance of discussing one’s wishes with the chosen proxy to ensure alignment with personal values. The document concludes with instructions for witnesses and the proxy's acknowledgment, reinforcing the legal validity of the individual’s choices. By filling out this form, individuals can ensure that their medical care aligns with their personal beliefs and preferences, providing peace of mind for themselves and their loved ones.
Misconceptions
Understanding the Alabama Directive Health Care form is essential for making informed medical decisions. However, several misconceptions can lead to confusion. Here’s a list of common misunderstandings:
- Misconception 1: You must have an advance directive.
- Misconception 2: An advance directive only applies to terminal illness.
- Misconception 3: You cannot change your mind once the form is signed.
- Misconception 4: A health care proxy must be named.
- Misconception 5: The health care proxy can make any decision without limitations.
- Misconception 6: The directive is only valid if signed by a lawyer.
- Misconception 7: Your wishes will always be followed, regardless of circumstances.
- Misconception 8: Life-sustaining treatment means all medical treatment.
- Misconception 9: Witnesses can be related to you.
This is not true. In Alabama, having an advance directive is optional. You can choose whether or not to create one.
While it does address terminal conditions, it also covers situations like permanent unconsciousness. It’s important to understand the full scope of the directive.
This is incorrect. You can change your mind at any time by tearing up the form and creating a new one or by verbally communicating your wishes to someone.
You are not required to name a health care proxy. If you choose not to, the directions in your form will still be followed.
This is misleading. You can specify the extent of the proxy's authority in your directive, including whether they can make decisions beyond what is listed.
In Alabama, the form does not need to be signed by a lawyer. It simply requires your signature and the signatures of two witnesses.
This is not entirely accurate. If you are pregnant, for example, your directives may not be followed until after the baby is born.
Life-sustaining treatment specifically refers to treatments that keep you alive without curing your condition. You will still receive comfort care even if you refuse these treatments.
This is false. Witnesses must not be related to you by blood, adoption, or marriage, and they should not stand to gain anything from your estate.
By clarifying these misconceptions, individuals can better navigate the complexities of their health care decisions and ensure their wishes are respected.
Example - Alabama Directive Health Care Form
AD V AN CE D I RECTI V E FOR H EALTH CARE
( Liv in g W ill a n d H e a lt h Ca r e Pr ox y )
This form may be used in the State of Alabama to make your wishes known about what medical treatment or other care you would or would not want if you become too sick to speak for yourself. You are not required to have an advance directive. If you do have an advance directive, be sure that your doctor, family, and friends know you have one and know where it is located.
Se ct ion 1 . Livin g W ill
I, ___________________, being of sound mind and at least 19 years old, would like to make the
following wishes known. I direct that my family, my doctors and health care workers, and all others follow the directions I am writing down. I know that at any time I can change my mind about these directions by tearing up this form and writing a new one. I can also do away with these directions by tearing them up and by telling someone at least 19 years of age of my wishes and asking him or her to write them down.
I understand that these directions will only be used if I am not able to speak for myself.
I f I be com e t e r m in a lly ill or in j u r e d:
Terminally ill or injured is when my doctor and another doctor decide that I have a condition that cannot be cured and that I will likely die in the near future from this condition.
Life sustaining treatment – Life sustaining treatment includes drugs, machines, or medical procedures that would keep me alive but would not cure me. I know that even if I choose not to have life sustaining treatment, I will still get medicines and treatments that ease my pain and keep me comfortable.
Place your initials by either “yes” or “no”:
I want to have life sustaining treatment if I am terminally ill or injured. ____ Yes ____ No
Artificially provided food and hydration (Food and water through a tube or an IV) – I understand that if I am terminally ill or injured I may need to be given food and water through a tube or an IV to keep me alive if I can no longer chew or swallow on my own or with someone helping me.
Place your initials by either “yes” or “no”:
I want to have food and water provided through a tube or an IV if I am terminally ill or injured.
____ Yes ____ No
I f I Be com e Pe r m a n e n t ly U n con sciou s:
Permanent unconsciousness is when my doctor and another doctor agree that within a reasonable degree of medical certainty I can no longer think, feel anything, knowingly move, or be aware of being alive. They believe this condition will last indefinitely without hope for improvement and have watched me long enough to make that decision. I understand that at least one of these doctors must be qualified to make such a diagnosis.
Life sustaining treatment – Life sustaining treatment includes drugs, machines, or other medical procedures that would keep me alive but would not cure me. I know that even if I choose not to have life sustaining treatment, I will still get medicines and treatments that ease my pain and keep me comfortable.
Place your initials by either “yes” or “no”:
I want to have
Artificially provided food and hydration (Food and water through a tube or an IV) – I understand that if I become permanently unconscious, I may need to be given food and water through a tube or an IV to keep me alive if I can no longer chew or swallow on my own or with someone helping me.
Place your initials by either “yes” or “no”:
I want to have food and water provided through a tube or an IV if I am permanently unconscious.
____ Yes ____ No
O t h e r D ir e ct ion s: Please list any other things you want done or not done.
In addition to the directions I have listed on this form, I also want the following:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
If you do not have other directions, place your initials here:
____ No, I do not have any other directions.
Se ct ion 2 . I f I ne e d som e one t o spe a k for m e .
This form can be used in the State of Alabama to name a person you would like to make medical or other decisions for you if you become too sick to speak for yourself. This person is called a health care proxy. You do not have to name a health care proxy. The directions in this form will be followed even if you do not name a health care proxy.
Place your initials by only one answer:
_____ I do not want to name a health care proxy. (If you check this answer, go to Section 3)
_____ I do want the person listed below to be my health care proxy. I have talked with this person
about my wishes.
First choice for proxy: ________________________________________
Relationship to me: __________________________________________
Address: ____________________________________________________
City: ____________________________ State _______ Zip ___________
If this person is not able, not willing, or not available to be my health care proxy, this is my next
choice:
Second choice for proxy: _______________________________________
Relationship to me: __________________________________________
Address: ____________________________________________________
City: ____________________________ State _______ Zip ___________
Instructions for Proxy
Place your initials by either “yes” or “no”:
I want my health care proxy to make decisions about whether to give me food and water through a tube or an IV. ____ Yes ____ No
Place your initials by only one of the following:
____ |
I want my health care proxy to follow only the directions as listed on this form. |
_____ |
I want my health care proxy to follow my directions as listed on this form and to make any |
|
decisions about things I have not covered in the form. |
_____ |
I want my health care proxy to make the final decision, even though it could mean doing |
|
something different from what I have listed on this form. |
Se ct ion 3 . Th e t h in gs list e d on t h is for m a r e w h a t I w a n t .
I understand the following:
§If my doctor or hospital does not want to follow the directions I have listed, they must see that I get to a doctor or hospital who will follow my directions.
§If I am pregnant, or if I become pregnant, the choices I have made on this form will not be followed until after the birth of the baby.
§If the time comes for me to stop receiving life sustaining treatment or food and water through a tube or an IV, I direct that my doctor talk about the good and bad points of doing this, along with my wishes, with my health care proxy, if I have one, and with the following people:
____________________________________________________________________
____________________________________________________________________
Se ct ion 4 . M y signa t ur e
Your name: _______________________________________________________
The month, day, and year of your birth: _________________________________
Your signature: ____________________________________________________
Date signed: _______________________________________________________
Se ct ion 5 . W it n e sse s ( n e e d t w o w it n e sse s t o sign )
I am witnessing this form because I believe this person to be of sound mind. I did not sign the person’s signature, and I am not the health care proxy. I am not related to the person by blood, adoption, or marriage and not entitled to any part of his or her estate. I am at least 19 years of age and am not directly responsible for paying for his or her medical care.
Name of first witness: ___________________________________
Signature: _____________________________________________
Date: _________________________________________________
Name of second witness: _________________________________
Signature: _____________________________________________
Date: _________________________________________________
Se ct ion 6 . Sign a t u r e of Pr ox y
I, ____________________________________________, am willing to serve as the health care proxy.
Signature: ________________________________________ |
Date: _________________________ |
Signature of Second Choice for Proxy:
I, __________________________, am willing to serve as the health care proxy if the first choice
cannot serve.
Signature: ________________________________________ |
Date: _________________________ |
Additional PDF Forms
Alabama Mvt 41 1 - Junk status must be indicated if the vehicle is sold for parts only.
Alabama Dmv License - Witnesses must be over eighteen years of age and unrelated to the parties involved.
In addition to understanding the purpose of a Release of Liability form, it is crucial for participants to also consider the implications of a Hold Harmless Agreement, which further protects the organizing party from claims of liability, ensuring that all involved are aware of their responsibilities and the risks they assume during the activities.
Alabama Business Privilege Tax Return - Filing the form accurately is crucial to avoid unnecessary penalties or complications.
Similar forms
The Alabama Directive Health Care form shares similarities with the Living Will, a document that allows individuals to outline their preferences for medical treatment in situations where they are unable to communicate. Like the Alabama form, a Living Will specifies the types of life-sustaining treatments a person desires or declines, such as resuscitation efforts or mechanical ventilation. Both documents serve to ensure that an individual's wishes are respected in critical health scenarios, providing clarity to family members and healthcare providers during difficult decisions.
Another related document is the Durable Power of Attorney for Health Care. This legal instrument enables a person to appoint a trusted individual to make medical decisions on their behalf if they become incapacitated. Similar to the health care proxy section of the Alabama Directive, this document empowers someone to act according to the individual's wishes regarding medical treatment. It emphasizes the importance of having a designated decision-maker who understands the individual’s values and preferences in health care matters.
The Physician Orders for Life-Sustaining Treatment (POLST) form is also comparable. This document is intended for individuals with serious illnesses and serves as a set of medical orders that healthcare providers must follow. Like the Alabama Directive, the POLST outlines specific medical interventions a patient wishes to receive or avoid, such as resuscitation and intubation. Both forms aim to ensure that a person’s treatment preferences are honored in emergency situations, bridging the gap between patient desires and medical practice.
The Do Not Resuscitate (DNR) order is another important document that aligns with the Alabama Directive Health Care form. A DNR specifically instructs medical personnel not to perform CPR if a patient’s heart stops or if they stop breathing. This order is similar in intent to the directives outlined in the Alabama form, as both documents communicate a person's wishes regarding life-sustaining measures. While the Alabama Directive covers a broader range of medical decisions, the DNR focuses solely on resuscitation efforts.
The Advance Health Care Directive is another document that bears resemblance to the Alabama form. This directive combines elements of a Living Will and a Durable Power of Attorney for Health Care, allowing individuals to specify their medical treatment preferences and appoint a health care proxy. Much like the Alabama Directive, it ensures that a person's wishes regarding medical care are clear and legally recognized, providing guidance for healthcare providers and loved ones during critical times.
For those who wish to outline their asset distribution clearly, filling out a Last Will and Testament form guide is essential in creating a legally sound document that reflects their last wishes and provides peace of mind.
Health Care Proxy forms are also similar to the Alabama Directive. These forms allow individuals to designate someone to make medical decisions on their behalf if they become unable to do so. The health care proxy section in the Alabama Directive serves the same purpose, emphasizing the importance of having a trusted person who can advocate for the individual's health care preferences. Both documents focus on ensuring that the appointed proxy understands and respects the individual's wishes.
The Mental Health Advance Directive is another relevant document. This form allows individuals to outline their preferences for mental health treatment in the event they become incapacitated. Similar to the Alabama Directive, it provides guidance to healthcare providers and loved ones about the individual's treatment preferences. Both documents empower individuals to take control of their health care decisions, even in circumstances where they cannot voice their desires.
Finally, the End-of-Life Care Plan is akin to the Alabama Directive Health Care form. This document allows individuals to articulate their preferences for care as they approach the end of life, including pain management and hospice care options. Like the Alabama Directive, it seeks to ensure that medical providers respect a person's wishes during critical moments. Both documents aim to facilitate discussions about end-of-life care and provide clarity to families and healthcare teams about the individual's desires.
Common mistakes
Filling out the Alabama Directive Health Care form is an important step in ensuring your medical wishes are honored. However, many people make common mistakes that can lead to confusion or unintended consequences. Here are nine mistakes to avoid when completing this essential document.
One frequent error is not providing clear and specific instructions. When indicating your preferences regarding life-sustaining treatment or artificially provided food and hydration, it’s crucial to be explicit. Simply marking “yes” or “no” without additional context can lead to misunderstandings. Take the time to articulate your wishes clearly.
Another mistake is failing to discuss your decisions with your chosen health care proxy. If you decide to name someone to make medical decisions on your behalf, ensure that person understands your wishes. This conversation is vital. Without it, your proxy may be uncertain about how to act in a critical situation.
Many individuals also overlook the need for two witnesses when signing the form. This requirement is essential for the document to be valid. Not having the appropriate number of witnesses can invalidate your directive, so ensure that you have two qualified individuals ready to sign.
Additionally, some people forget to update their directive after significant life changes. Events such as marriage, divorce, or the death of a proxy can affect your wishes. It’s important to review and revise your directive periodically to reflect your current preferences.
Another common oversight is neglecting to inform family members about the existence and location of the directive. Even if you have filled out the form correctly, it will not be effective if your loved ones do not know it exists. Make sure they are aware of your wishes and where to find the document.
Some individuals mistakenly assume that they do not need to initial every section. Each choice you make on the form requires your initials to confirm your decisions. Skipping this step can create ambiguity about your preferences.
Another error involves not considering the implications of your choices. For example, some people may hastily decide against life-sustaining treatment without fully understanding the consequences. Take the time to think through your decisions and consult with medical professionals if needed.
Lastly, many individuals forget to sign and date the form. This step is crucial for its validity. Without a signature, the directive cannot be considered legally binding, which defeats the purpose of having it in the first place.
By avoiding these common mistakes, you can ensure that your Alabama Directive Health Care form accurately reflects your wishes and is legally valid. This proactive approach will give you peace of mind, knowing that your preferences will be honored when it matters most.