The following questionnaire has been designed to elicit your feelings about what health care you would be willing to receive, and whom you would want to make decisions for you if you could not make them yourself. Please review this carefully and furnish the requested information.
The U.S. and Florida Constitutions guarantee you the right to decide what medical treatment you will accept and what you will decline. Unless you provide clear and convincing evidence of your wishes while you are competent, incapacity could deprive you of this right when its exercise becomes crucial. You may now authorize someone you select, called a "Surrogate," to make health care decisions for you if you become unable to make them yourself. The unfortunate court cases that have dealt with this issue have all involved people who had not clearly expressed their wishes.
You have the legally enforceable right to express your views on what medical treatment should occur if you were to develop a terminal condition, i.e., a condition from which there is no reasonable possibility of recovery which, without treatment, can be expected to cause death in the near future. You may then prefer to have medical treatment withheld or withdrawn if such treatment only prolongs the process of dying.
You also have the right to direct your treatment if you are in a persistent vegetative state. You may feel that you would not want to be kept alive by a respirator or other life-sustaining treatment. You may also feel that food and water should no longer be administered mechanically.
If you become incompetent (physically or mentally unable to communicate your medical treatment decisions) and you suffer from a terminal condition or are in a persistent vegetative state, your medical treatment decisions will be based on your wishes expressed by you while you were competent if you have, in fact, expressed such wishes. If you have not expressed your wishes while competent, medical treatment will be continued for you if you become incompetent and suffer from a terminal condition or are in a persistent vegetative state.
WHAT TO EXPECT
We suggest expressing all your wishes on these topics in two documents. A Living Will and a Health Care Declaration and Designation. The Living Will is a short document relating only to life-prolonging care, treatment, services and procedures. The Health Care Declaration and Designation is a longer document where we try to anticipate the reasonably foreseeable circumstances in which health care decisions may have to be made. Even so, we cannot guarantee that all physicians and hospitals will act in accordance with either the Living Will and/or the Health Care Declaration and Designation. Also, the law prevents health care facilities from denying you medical treatment or discriminating against you if you do not have a Living Will and/or a Health Care Declaration and Designation.
CHANGING YOUR MIND
Please understand that you will continue to make medical decisions for yourself as long as you retain the capacity to do so. You may also change or revoke either document at any time while you have the capacity to do so.