Patients & Visitors

Advance Directives

All adult individuals in health care facilities such as hospitals, nursing homes, hospices, home health agencies, and health maintenance organizations, have rights under Florida Law.

You have the right to fill out a paper known as an "Advance Directive." The paper says in advance what kind of treatment you want or do not want under special, serious medical conditions - conditions that would stop you from telling your doctor how you want to be treated. For example, if you were taken to a health care facility in a coma, would you want the facility's staff to know your specific wishes about decisions affecting your treatment?


Questions Commonly Asked About Advance Directives
What is an Advance Directive?

An Advance Directive is a written or oral document that is made and witnessed in advance of serious illness or injury, about how you want medical decisions made. Two forms of advance directives are:
"Living Will"
"Health Care Surrogate Designation."
An Advance Directive allows you to write out for permanent record - your choices about health care or to name someone to make choices for you, if you become unable to make decisions about your medical treatment. An Advance Directive enables you to make decisions about your future medical treatment.


What is a Living Will?

A Living Will generally states the kind of medical care you want or do not want if you become unable to make your own decisions. It is called a "Living Will" because it takes effect while you are still living. Florida law provides a suggested form for a Living Will. You may use it or some other form. You may wish to speak to an attorney or physician to be certain you have completed the living will in a manner that your wishes will be understood.


What is a Health Care Surrogate Designation?

A "health care surrogate designation" is a signed, dated and witnessed paper naming another person such as a husband, wife, daughter, son or close friend as your agent to make medical decisions for you, if you should be unable to make them for yourself. You can include instructions about any treatment you want or wish to avoid. Florida law provides a suggested form for the designation of a health care surrogate. You may use it or some other form. You may wish to name a second person to stand in for you, if your first choice is not available.


Which is better - a Living Will or a Health Care Surrogate Designation?

You may wish to have both or combine them into a single document that describes treatment choices in a variety of situations and names someone to make decisions for you should you be unable to make decisions for yourself.


Do I have to write an Advance Directive under Florida law?

No, there is no legal requirement to complete an Advance Directive. However, if you have not made an Advance Directive or designated a health care surrogate, health care decisions may be made for you by a court appointed guardian, your spouse, your adult child, your parent, your adult sibling, and adult relative or a close friend, in that order. This person would be called a proxy.


Can I change my mind after I write a Living Will or designate a Health Care Surrogate?

Yes, you may change or cancel these documents at any time. Any change should be written, signed and dated. You can also change an advance directive by oral statement.


What if I have filled out an Advance Directive in another state and need treatment in a health care facility in Florida?

An Advance Directive completed in another state, in compliance with the other state's law, will be honored in Florida.


What should I do with my Advance Directive if I choose to have one?

Make sure that someone such as your doctor, lawyer or family member knows that you have an Advance Directive and where it is located. Consider the following:
- If you have designed a health care surrogate, give a copy of the written designation form or the original form to the person.
- Give a copy of your Advance Directive to your doctor for your medical file.
- Keep a copy of your Advance Directive in a place where it can be found easily.
- If you change your Advance Directive, make sure your doctor, lawyer, and/or family member has the latest copy.



For further information ask those in charge of your care.

The above information was provided courtesy of the Agency for Health Care Administration based on Rule 59A-3.190 Advance Directives.

Blake Medical Center Policy -- Advance Directives
1. The hospital shall respect and honor your health care decisions, as required or allowed by law.

2. You are not required to give advance health care decisions in order to receive care or treatment at this hospital.

3. Hospital personnel shall provide each adult individual, upon admission, with this copy of the AHCA(TM)s "Health Care Advance Directives -- The Patient's Right To Decide." This is an overview of the major hospital policy points concerning Advance Directives. The "Living Will" and "Designation of Health Care Surrogate forms, with the legal requirements of each, are available to anyone by contacting the Information Desk in the Lobby or the Department of Quality Utilization Review.

4. Each admission, you will be asked about your Health Care Advance Directives and be requested by provide a copy of the document. We want to be certain that the document is valid and reflects your current decisions about acceptance or refusal of medical treatment.

5. Hospital personnel will request and document in your medical record, whether you have executed an Advance Directive, a Living Will, or named a person to speak on your behalf, if you are unable to do so. You will be asked to provide that person's (surrogate or proxy) name, address and phone number, and your relationship to the designed person. The information will be noted in your medical record. A copy of the document will be requested and put in your record so all health care providers are aware of your wishes. If the document is not available at the time of admission, your family member or representative will be asked to bring a copy to the hospital, and taken to the nursing unit where care is being provided. At that time, the document or a copy of the original shall be placed within the medical record.

6. The patient is responsible for discussing his/her future health care wishes with his/her physician and family or representative and making his/her wishes known.

7. The patient or his representative may choose to contact his/her physician, hospital care manager or social worker, or his/her attorney if questions arise about Advance Directives. Legal issues should be discussed with your attorney.

8. Hospital policy on Advance Directives is available for review upon request. Contact Directors/Designee or Quality/ Utilization Management. If a conflict arises regarding acting as you have directed in the Advance Directive, Blake Medical Center shall follow the administrative policy on Advance Directives.

9. Blake Medical Center promotes the education and availability of information regarding Health Care Advance Directives as part of its community service.

10. If ethical issues or concerns arise, patients and/or representatives may access the Hospital Ethics Committee or consultation regarding ethics by requesting to speak with the Directors, Case Manager, Risk Manager, or Administrator for guidance.


Please be aware, if patient lacks capacity to make an informed health care decision, the attending physician shall evaluate patient's capacity. If the physician concludes that patient lacks capacity, another physician shall evaluate patient's capacity. Each shall evaluate and document their findings in the patient's clinical record. If health care surrogate has been designated, the facility shall notify surrogate in writing that his/her duty has commenced. If no surrogate identified, proxy will be contacted.