Can advance directives be verbal?

In certain situations, a patient with decision-making capacity may report for care when they are seriously ill and loss of decision-making capacity is imminent. In such situations, the VA will document the patient's unambiguous verbal or non-verbal instructions regarding preferences for future health care decisions. These instructions will be followed and enforced in the event that the patient loses the ability to make decisions before a new advance directive can be completed. The patient's instructions must have been expressed to at least two members of the health care team.

To confirm that the patient's verbal or non-verbal instructions are, in fact, unambiguous, the contents of the patient's instructions and the names of at least two health care team members to whom they have been expressed should be recorded in the patient's electronic medical record. You can give verbal instructions to your doctor and your family. However, it is more useful to put your wishes in writing. A patient with decision-making ability may revoke an advance directive or directive in a critical situation at any time using any means that expresses an intention to revoke.

Florida will recognize an advance directive executed in another state as long as it meets the requirements of that state or the state of Florida. To do this, they must consider previously stated wishes, as per their advance directives (to the extent they apply), verbal statements (to the extent they apply), and knowledge of their religious and moral goals, values and beliefs. To elucidate the full scope of legal barriers to advance directives, subsequent studies should attempt to identify cases that have only progressed to an ethics review board or to lower state courts. Documents such as advance directives can help ensure that your loved ones and your healthcare team follow your wishes.

In addition, all states have immunity statutes that protect physicians from criminal or civil liability or disciplinary action if they act on the information of an advance directive in “good faith.” We exclude referrals to court-appointed guardians, authority of agents for pregnant patients, and psychiatric directives. Although it may be uncomfortable to think about these situations, planning ahead gives you and your family members peace of mind and helps eliminate confusion at a difficult time. To the witness's knowledge, none of the witnesses may be named a beneficiary in the patient's estate, named a health care agent in the advance directive, or financially responsible for the patient's care. As an alternative to such patient or surrogate using an “X”, fingerprint or stamp duly witnessed to sign the form, a designated third party may sign the form if acting under the direction of the patient or substitute and in the presence of the patient or substitute.

If the patient is unable to sign a VA advance directive due to a physical disability, the patient may sign the advance directive form with an “X”, fingerprint, or stamp. Unless related to the principal by blood, marriage, civil union, or adoption, an agent cannot be the owner, operator, employee, agent or contractor of a residential care facility, health care facility, or correctional facility in which the principal resides at the time of execution of an advance directive.

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