Alabama Natural Death Act VS. Advanced Directives
No one likes to ponder their own mortality. However, an Advanced Directive does just that. They are an individual’s written instructions to others regarding the medical treatment and health care they would want when he/she cannot articulate those wishes. An Advanced Directive enables an individual to appoint a proxy to speak for them if they are unable to make decisions, and it provides instructions to treating physicians which cannot be voiced at the time.
In such cases where individuals fail to make the necessary Advanced Directive to deal with end of life issues their families are left to make decisions without written instructions from their now incapacitated loved one. In such a circumstance, the Alabama Natural Death Act provides for the appointment of a surrogate to make treatment and end of life decisions. Once two physicians have determined that the individual is incapacitated and has a terminal condition, a surrogate is appointed on the following order of priority:
- Court appointed Guardian
- Patient’s Spouse
- Adult Child
- Adult Sibling
- Relatives of the next closest degree
- If no relatives are known or none can be found, a committee composed of the patient’s primary treating physician and the facilities ethics committee. The committee must notify DHR and allow review of any decisions.
It should be noted that a Court appointed Guardian lacks the authority to make end of life decisions unless that power is specifically granted by the Court in the appointing Order.
Once the surrogate is appointed, they are empowered to make decisions regarding end of life issues such as types of medication, surgery, food and water provided through tubes, blood transfusions, cardiopulmonary resuscitation (CPR) and mechanical respirators.
The best policy, as always, is to plan ahead for every eventuality. Rather than letting your fate be determined by a committee of doctors sitting in a conference room, everyone should have an Advanced Directive. Advanced Directives provide peace of mind to all parties and avoid conflict over what others believe to be your wishes or in your best interest.