Advance Directives

Every person has the right to have an advance directive. An advance directive is a document that you should fill out before you need hospitalization. It designates how you want your healthcare to be delivered in the event that you are not mentally or physically able to make that decision yourself.

It also allows you to name a trusted person to make these choices for you if you become unable to do so. Without an advance directive, someone you may not know could make decisions about important healthcare choices, such as extraordinary life-support, cardiopulmonary resuscitation (CPR), feeding tubes or a ventilator for artificial breathing.

An advance directive may include:

• Living Will
• Healthcare Surrogate Designation
• Power of Attorney

During the admission process at Orlando Health Bayfront Hospital St. Petersburg, you will be asked if you have an advance directive. If you have one, please bring the forms with you to the hospital admitting office when you check in. If you do not, you may ask for information about a living will and/or healthcare surrogate and the appropriate forms. Your nurse or a social worker also can provide you with the forms.

A Living Will

A living will is a written statement that generally states the type 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. Under Florida law, you may make a living will and direct the providing, withholding or withdrawal of life-prolonging procedures in the event that you have any of the following:

• A terminal condition caused by injury, disease or illness from which there is no reasonable medical probability of recovery and that, without treatment, can be expected to cause death
• An end-stage condition caused by disease or illness that has resulted in progressively severe and permanent deterioration and, to a reasonable degree of medical probability, treatment of the condition would be ineffective
• Are in persistent “vegetative” state, or permanent and irreversible condition of unconsciousness in which there is:
  • The absence of voluntary action or cognitive behavior of any kind
  • An inability to communicate or interact purposefully with the environment

Healthcare Surrogate

A healthcare surrogate form is a signed, dated and witnessed document naming another person such as a husband, wife, son, daughter or another close relative or friend as your agent to make medical decisions for you if you become unable to make them yourself. Following your wishes, a healthcare surrogate can give informed consent, review medical records, talk with doctors, authorize transfer, apply for public healthcare benefits and consent to organ and tissue donation. You also can include instructions about any treatment you do not want. You may name a second person to stand in if your first choice is not available.

Power of Attorney

A power of attorney is a legal document that allows someone to act as your agent, usually for business and financial matters. You may specify that this person can make healthcare decisions for you.

You may complete the advance directive found in this informational packet, print it out and bring it to the Admissions Department at Orlando Health Bayfront Hospital St. Petersburg to be included in your medical records.