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Planning for Incapacity - Advance Directive for Health Care
 
Oklahoma’s Advance Directive Act (63 O.S. §§ 3101.1 – 3101.16) was enacted to give patients control over their medical treatment when they are unable to communicate their wishes in person. The Advance Directive for Health Care gives you the opportunity to:  
  • decide in advance whether you would like to receive life-sustaining treatment
  • appoint a health care proxy to make medical decisions on your behalf
  • elect or decline to donate body parts or your entire body for transplantation or research
Deciding Whether or Not to Receive Life-Sustaining Treatment  
 
The first section of Oklahoma’s Advance Directive form allows you to elect or decline life-sustaining treatment. Specifically, your choices are:
  • request all life-sustaining treatment be administered
  • decline all life-sustaining treatment
  • decline all life-sustaining treatment except artificially administered nutrition and hydration
  • give more specific instructions
You can make this choice for each of the following scenarios:  
  • if you ever have a terminal condition
  • if you are ever persistently unconscious
  • if you ever have an end-stage condition
  • other conditions described by you 

More on Deciding Whether or Not to Receive Life-Sustaining Treatment

 
Choosing a Health Care Proxy   
 
The second section of the Advance Directive form allows you to designate a health care proxy. This is a person who will make medical decisions on your behalf if you are unable to do so. Usually it is best to name one primary health care proxy and at least one successor proxy if your primary health care proxy is unable or unwilling to serve.
 
Your health care proxy is required to make decisions based on your “known intentions, personal views and best interests.”
63 O.S. § 3101.16. If there is insufficient evidence of your wishes, the health care proxy must use reasonable judgment based on his or her understanding of your values and what you would have wanted in the given situation.
 
It is therefore critical that you
discuss your wishes and values with your health care proxy ahead of time. You may also want to give your health care proxy any written exercises or other documentation of your wishes that you complete.
 
When deciding who to name as your health care proxy, consider the following criteria:  
  • Can this person legally act as your health care proxy? – Oklahoma requires a health care proxy to be at least 18 years old.
  • Is the person willing? – Ask permission first to name someone as your health care proxy.
  • Will the person be available? – Does the person live close by or can he or she travel quickly if needed? Does the person have other responsibilities that would prevent him or her from being available when needed?
  • Will the person be able to carry out your wishes? – Will the person be able to separate his or her feelings from yours?
  • How well does this person know you and understand your values? – If there is insufficient evidence of what you would want in a particular situation, Oklahoma law requires a health care proxy to use reasonable judgment about your values to determine what you would wish to happen.
  • Is this someone you trust absolutely? – Remember, you may be entrusting this person with your life. You should have absolute confidence in his or her judgment and integrity.
  • Is this person willing to talk with you about sensitive issues? – Make sure this person is willing to discuss illness, death and dying.
  • Will this person be able to ask medical personnel questions and advocate on your behalf? – Your health care proxy should not be too timid to ask questions or to make sure you get the care you need. Your pushy niece may be a better choice than your shy son.
  • Will this person be able to handle conflict? – There may be some who disagree about the best course of action. You should choose a health care proxy who will be able to handle these conflicts and focus on carrying out your wishes.
  
Anatomical Gifts   
 
The third section of the Advance Directive form gives you the option of donating your entire body or designated body parts.
 
 
How To Compete an Advance Directive for Health Care   
 
Advance Directive forms can be obtained for free from the Oklahoma Department of Human Services by calling 877-283-4113 or 405-962-1721. Forms can also be downloaded for free from a variety of websites, including this one. English, Spanish and Vietnamese forms can be downloaded from the Oklahoma Palliative Care Resource Center's website.
 
Many attorneys and health care providers will provide clients with the forms at no charge.
To complete an advance directive, a person must be at least 18 years old and be of sound mind. Read the option carefully and initial (don’t just mark an X or checkmark) each choice that you make.
 
Sign and date the form at the end where indicated and write the city and county where you currently reside. You have the option of writing your birth date for identification purposes.
 
Sign the form in front of two witnesses who are at least 18 years old, not related to you by blood or marriage, and not going to inherit from you. Neither your health care proxy nor your alternate health care proxy should be a witness. Have each witness sign the form and fill in their address where indicated.
 
You do not need an attorney to complete an Advance Directive, nor do you need to have it notarized. The Senior Law Resource Center provides free assistance with completing advance directives. Contact us at 405.528.0858 or
info@senior-law.org to make an appointment.
 
What To Do With Your Advance Directive  
  
Once you have completed your advance directive:
  • Keep a copy for yourself in a place where it can be easily accessed
  • Give copies to your health care proxy and alternate health care proxy
  • Give a copy to your physician(s) who will make it a part of your medical record
  • Give a copy to a staff member of the assisted living center or nursing home (if applicable)
  • Give a copy to your attorney (if applicable)
Once you have completed your advance directive, keep a copy for yourself in a place where it can be easily accessed. Consider putting one copy on your refrigerator and another copy in your glove compartment.
 
Do not keep your advance directive in a safe deposit box or locked away. You may also want to carry a card in your wallet and/or glove compartment indicating you have an advance directive, where a copy can be located and the name and contact information for your health care proxy.
 
Give copies to your health care proxy and alternate health care proxy. You may want to give them any worksheets or notes you have made about your wishes. Also, record your personal and medical information and either give a copy to your health care proxy or tell him or her where to find it if needed. This information should include:
  • Your full name
  • Your date of birth
  • Your address and phone number
  • Name and contact information of your physician(s)
  • Name and contact information of your next of kin
  • Allergies
  • Diagnosis
  • Health limitations such as impaired vision, hearing, walking or speech
  • List of medications (prescription and over the counter)
  • Whether you have a pacemaker or other implant
 
Give a copy of your advance directive to your physician(s) who will make it a part of your medical record. Make sure your physician is willing to comply with your wishes. Oklahoma law requires physicians or health care providers to promptly inform you if they are not willing to comply. 63 O.S. §3101.4.
 
If you live in an assisted living facility or nursing home, give a copy to a staff member who can make it a part of your file.
 
Give a copy to your attorney, if you have one.
 
Review your advance directive and related documents every few years, especially after a major life change such as the death of a loved one, divorce, or a diagnosis of a serious medical condition. If your current advance directive no longer reflects your wishes, revoke your old one and complete a new one. Update the personal and health information sheet for your health care proxy as needed.
 
How To Revoke or Change an Advance Directive   
 
You can revoke all or part of your advance directive at any time and in any manner. Tell your attending physician that you revoke your advance directive and to make your revocation part of your medical record. It is best to document your revocation by writing “I revoke” across each page of your advance directive and keeping it for your records. Tell everyone who has a copy of your advance directive that is has been revoked and ask them destroy their copies.
 
You can also revoke your advance directive by completing a new one. If you then revoke your latest advance directive, that will not bring an earlier one back into effect. You will have to complete a new advance directive.
 
To change your advance directive, complete a new form. Do not make changes to the old form. Changes made to an already-executed form may not be valid because they are not witnessed.
 
Expressing Your Wishes
 
When trying to articulate your wishes and values, ask yourself the following questions:
  • What do you value most about your current life?
  • What activities give you the most satisfaction in life?
  • What do you fear about the end of life?
  • How do you feel about being dependent on others?
  • If you could choose, what would you do during the last week of your life?
  • How important are the wishes of your children or other loved ones regarding your end-of-life choices?
  • How are your wishes influenced by your religious or spiritual beliefs?
  • What spiritual support, if any, do you want at the end of your life? 
Making Sure Your Wishes Are Honored

Completing an advance directive is just the first step to ensuring your wishes are honored. Share your wishes and values with your health care proxies, family members and your physician(s) either verbally or written down.
 
 

Subpages (4): Anatomical Gifts Health Care Proxy Role Life Sustaining Treatment Decisions Talking with Proxy