Ethics and Patient Rights

About Advance Directives

An advance directive is a written document made in advance of serious illness or sudden accident that states your choices for health care, and may name someone to speak for you if you become incompetent. You may choose to prepare one, both or none of the following types of advance directives:

Compare your legal options before deciding how to proceed with these advance directives.

What you should do with your advance directive

Ideally, you should discuss your values and wishes with your family, friends, and health care providers as part of the process of making an advance directive. In any case, let all of these people know that you have an advance directive. Keep it in a safe place where it can be easily found if it is needed. You should give a signed copy to your medical doctor, as well as to your agent.

When you enter a hospital or other health care facility, you will be asked whether you have an advance directive. If you do, the facility will also note it in your medical record. If you know you will be admitted to a health care facility, you should bring copies of your advance directive(s) with you.

You aren't legally required to sign an advance directive...

Whether to sign an advance directive is entirely your decision. The law requires only that you be told about your legal rights to fill out an advance directive, and that the health care provider must note in your medical record if you have signed one. No one may refuse to provide you with health care services or insurance if you choose not to sign an advance directive.

...but signing one can help you and your family in the long run

It makes good sense to consider signing an advance directive and to think about your present medical care values before a medical crisis, while you are still able to do so. You should discuss with family and friends such personal issues as:

  • the significance of death
  • the conditions that could make the dying process intolerable and
  • the way artificial life support would affect the dying process.

What happens if you choose not to prepare an advance directive

If you do not have an advance directive and you become unable to speak for yourself, your health care decisions will be left to a legal guardian if one has been appointed. In the absence of an advance directive or court-appointed legal guardian, your medical caregiver will work with you and your family to make appropriate decisions for your specific situation.

No one may make any assumptions about your intentions simply because you chose not to sign, or revoked, an advance directive.

If you are not a Rhode Island resident

A durable power of attorney for health care or a living will executed in another state in compliance with the laws of that state (such as, in Massachusetts, a health care proxy) will be legally effective in Rhode Island.

If you are pregnant

A durable power of attorney for health care, or a living will, will not be followed if you're pregnant and your doctor believes the fetus could develop to the point of live birth with the use of life-sustaining procedures.

Being prepared in case of emergency situations

If you are in a terminal condition and have signed a durable power of attorney for health care or a living will and you don't want to be resuscitated if your heart stops working, your doctor may ask the Rhode Island Department of Health for an identification bracelet. This bracelet, called a Comfort One, must be worn by you at all times in order to alert emergency medical personnel of your wishes.