WHAT ABOUT “PULLING THE PLUG”?

The laws of Louisiana uphold the fundamental right of all persons to control the decisions relating to their own medical care, including the decision to have life-sustaining procedures withheld or withdrawn in instances where such persons are diagnosed as having a terminal and irreversible condition. The laws provide a means through which the rights of patients may be respected even after they are no longer able to participate actively in medical decisions in their own behalf. That means it is a Declaration Concerning Life-Sustaining Procedures, better known as a LIVING WILL.

WHAT IS A LIVING WILL?

A Living Will in Louisiana is a legal document which describes the medical care that a person would wish should he/she be in a continual “profound comatose state with no reasonable chance of recovery or become terminally and irreversibly ill and no longer competent or able to participate in the decisions regarding his/her medical care.”

WHO MAY EXECUTE A LIVING WILL?

Any adult person may, at any time, make a written declaration instructing his/her physician to withhold or withdraw life-sustaining procedures in the event he/she should have a terminal and irreversible medical condition, or be in a continual profound comatose state with no reasonable chance of recovery, with the following stipulations:

1. The written declaration must be signed by the person making it in the presence of two witnesses, who must also sign the declaration.

2. The witnesses must be competent adults who must not be entitled to any portion of the estate of the person upon his/her death.

3. An oral or nonverbal declaration may also be made by an adult in the presence of two witnesses; as described in Section 2 above, by any non written means of communication. However, while a written declaration may be made at any time, an oral or nonverbal declaration may be made only AFTER the diagnosis of a terminal and irreversible condition or of a continual profound comatose state with no reasonable chance of recovery has been made.

RESPONSIBILITY TO NOTIFY PHYSICIAN

It is the responsibility of the person making the declaration to notify his/her attending physician that a declaration has been made in the event, however, that the person who made the declaration is mentally or physically incapable of communication, any other person may notify the physician of the declaration, i.e., that a Living Will exists.

WHO ELSE MAY EXECUTE A LIVING WILL?

Provided that a patient has not previously made a declaration, the laws give the following persons, in the following order of priority, the right to make a declaration on an adult patient's behalf to withhold or withdraw life-sustaining procedures should the patient be comatose, incompetent, or otherwise physically or mentally incapable of communication and be diagnosed and certified as having a terminal and irreversible condition or be in continual profound comatose state with no reasonable chance of recovery:

1. The court-appointed guardian of the patient, if one has been appointed.

2. The patient's spouse, not legally separated.

3. The patient's adult children, as a class.

4. The patient's parents, as a class.

5. The patient's brothers and sisters, as a class.

6. The patient's relatives, ascending or descending, as a class. In any case where the declaration is made by other than a court appointed guardian, the decision must be a unanimous one on the part of those members of the class reasonable available for consultation. Furthermore, at least two witnesses, as described earlier, must be present at the time the declaration is made.

WHAT ABOUT A MINOR?

If a minor has been diagnosed and certified as having a terminal and irreversible condition, or as being in a continual profound comatose state with no reasonable chance of recovery, the following persons may voluntarily make a declaration relative to withholding or withdrawal of medical treatment or life-sustaining procedures on the minor's behalf:

1. The spouse, if he/she has reached the age of majority; or

2. If there is no spouse, or if the spouse is not available, or is a minor, or is otherwise unable to act, then either the parent or guardian of the minor. Such declaration on behalf of a minor must be signed by the person making the declaration in the presence of two competent witnesses, as described previously, who must also sign the declaration.

However, an individual named above may not make a declaration if he/she has actual notice of contrary indications by the terminally ill minor, or if, as a parent or guardian, he/she has actual notice of opposition by another parent, or guardian, or a spouse who has attained the age of majority.

OTHER SPECIFIC DIRECTIONS

A person may add other specific provisions to the Living Will in the area above the signature.

Tissue or Organ Donation: If any of my tissues or organs are sound and would be of value as transplants to other people, I freely give my permission for such donation.

DESIGNATING ANOTHER PERSON

If an adult person does not choose to make his/her treatment decision and declaration, the law permits him/her to designate another person to make the treatment decision and make such a declaration for him/her in the event he/she is diagnosed as having a terminal and irreversible condition or in a continual profound comatose state with no reasonable chance of recovery and is unable to participate actively in medical decisions in his/her own behalf. In such a circumstance, the person may execute a Durable Power of Attorney (the person designated need not be a lawyer) in the following, or a similar form, signed and dated by declarant and signed by two witnesses.

CAN A LIVING WILL AFFECT INSURANCE?

No. The making of a declaration or the withholding or withdrawal of life sustaining procedures from an insured, qualified patient in accordance with Louisiana laws shall not affect the sale, procurement, or issuance of any life insurance policy, nor shall it invalidate or change the terms of any insurance policy, regardless of what the policy may say to the contrary. Furthermore, the removal of life support systems according to these laws shall not, for any purpose, constitute suicide, nor shall it be deemed the cause of death for purposes of insurance coverage.

CAN A LIVING WILL BE REVOKED?

Yes, Louisiana laws provide that a Living Will declaration may be revoked at any time by the person who made the declaration without regard to his/her mental state or competency by any of the following methods: by being cancelled, defaced, obliterated, burned, torn or otherwise destroyed by the person who made the declaration or by some person in his/her presence and at his/her direction; or by a written revocation of the person who made the declaration expressing the intent to revoke, signed and dated by the person; or by an oral or nonverbal expression by the person who made the declaration or the intent to revoke the declaration.

NOTE: Revocation of a Living Will declaration by any of the above methods shall become effective upon communication to the attending physician.

For additional information and assistance before reaching a decision, you are urged to consult with your physician, attorney, clergyman and family. Hospital personnel will be happy to put you in touch with the chaplain, social worker, or other qualified professionals.

Reference: Louisiana Revised Statutes, §1299.58.1.  Redesignated to R.S. 40:1151 by HCR 84 of 2015 R.S.