Advance Healthcare Directives
Your rights to decide about your healthcare
Dear Friend of Beebe,
Thank you for your interest in Beebe Medical Center's policy on Advance Directives. As you may know, Delaware passed the "Death with Dignity" Act in December of 1991. It was then amended as the "Health Care Decisions" Act in June of 1996 to better reflect the needs expressed by healthcare providers, potential patients, and clergy. Basically, there are two types of Advance Directives in Delaware: End of Life Decisions (formerly the Living Will) and Power of Attorney for Health Care. Beebe Medical Center has had formal policies on Advance Directives since 1991 that are available for you to review.
Because medical decision-making is such a personal matter, and because many states have varying laws regarding this topic, many aspects are still a matter of legal interpretation. Beebe encourages you to learn as much about Advance Directives as possible. There are two resources available, the Division of Aging at 302-422-1386 or the Delaware Office of the Public Guardian at 302-856-5313. Another option is to contact your personal attorney.
If you have a question about our policy or would like assistance completing your Advance Directive, contact the Patient Advocate at 645-3547 or ext. 547. If and when you execute this document, we ask that you keep the original and provide the hospital with a photocopy each time you are admitted. Be sure to make additional copies for your physicians, family members, clergyman, etc.
We applaud you for taking the initiative to become educated about Advance Directives. At Beebe Medical Center we believe that our best patient is an informed patient.
Director, Patient Relations
|Ercilia Arias, MD
Chairman, Bioethics Committee
About Advance Healthcare Directives
Who decides what healthcare I get?
As a competent adult, you have the legal right to make your own healthcare decisions. Your doctor or another healthcare professional may advise you and make recommendations about treatment. You have the right to receive this information in a way you can understand. You have the authority to say "yes" to any treatment that is offered to you and to say "no" to any treatment that you do not want.
What if my medical condition makes me unable to decide?
In Delaware, if you are at least 18 years old you may make a written "Advance Health Care Directive" to accept or refuse most healthcare treatments or procedures. Your Advance Health Care Directive will tell your doctor what you want if you become unable to decide yourself.
What is an Advance Health Care Directive?
Under Delaware law there are two types of Advance Health Care Directives:
- End of Life Instructions (Living Will) or
- A Power of Attorney for Health Care
An End of Life Instruction, previously referred to as a living will, is a written statement of your wishes about healthcare treatment if you have a terminal illness or are permanently unconscious for at least four weeks.
A Power of Attorney for Health Care allows you to name another person as an agent to make healthcare decisions for you if your medical condition makes you unable to do so. You can appoint any adult over the age of 18 to be your agent. However, if you are a resident of a long-term care facility, the agent cannot be an employee of the facility unless he/she is related to you. If you do not have an Advance Health Care Directive, a member of your family will be asked to make healthcare decisions for you when you are unable to do so. If you want to initiate an Advance Health Care Directive, you must do so while you are still capable and competent to make healthcare decisions. Two witnesses who are at least 18 years old must watch you sign the Advance Health Care Directive. You must choose witnesses who are not members of your family, will not inherit anything from you when you die, and do not have to pay for your care. If you are in a hospital, nursing home, or similar facility when you sign your written instruction, you must choose witnesses who are not employees of the facility. In addition, if you are in a nursing home or similar facility, one of the witnesses must be a Long-Term Care Ombudsman or the Public Guardian.
Does an Advance Health Care Directive apply when I am pregnant?
Delaware law provides that life-sustaining procedures cannot be withheld or withdrawn from a pregnant patient, so long as it is probable that the child will develop to the point of live birth with the application of life-sustaining treatment.
Where should I keep my Advance Health Care Directive?
You should keep the original and give copies to your family members, your doctor, and other healthcare providers. It will become part of your medical record. If you want, you can also give copies to close friends, your lawyer, or your clergyman.
What if I change my mind?
You can revoke your Advance Health Care Directive at any time by destroying it, by making a new one, or by telling two people at the same time that you no longer wish your Advance Health Care Directive to be effective. You should also, in writing, inform your doctor or any other healthcare provider and any health agent you have named of your decision to revoke the directive.
Will my Advance Health Care Directive be valid in another state?
State laws vary considerably on Advance Health Care Directives. While the Advance Health Care Directive you make in one state may be good in another state, there is no guarantee of that. If you move to another state, you should make a new Advance Health Care Directive in that state. If you have a valid Advance Health Care Directive from another state, it will be valid in Delaware to
the extent it is consistent with Delaware law.
What happens if I make no Advance Health Care Directive?
You are not required to make an Advance Health Care Directive. However, without an Advance Health Care Directive, a member of your family, who may be referred to as a surrogate, will be asked to make healthcare decisions for you. The following family members, if available, will be asked in this order:
- Spouse (husband or wife)
- Adult child
- A parent
- Adult brother or sister
- Adult grandchild
Adult niece or nephew
If none of these family members are available to make health decisions for you, a guardian may be appointed by the Court.
Where can I obtain more information?
If you would like more information, please contact Beebe Medical Center
302-645-3547. In addition, you can consult:
- Delaware Department of Health & Social Services, Division of Services for Aging with Physical Disabilities
- Delaware Office of the Public Guardian
Download the Advance Health Care Directive document (PDF)