Louisiana Living Will Requirements

Introduction

Key Things to Know

1. 1

   Louisiana's statute never uses the phrase "living will"; it calls this document a declaration, under the state's own Declarations Concerning Life-Sustaining Procedures law. A declaration is your written or spoken statement of which life-sustaining procedures you want withheld or withdrawn if you cannot speak for yourself; it does not name who decides for you.

2. 2

   A living will is not a last will and testament. A living will addresses medical treatment while you are alive but unable to communicate; a last will and testament governs who inherits your property after you die. Most people preparing one eventually want the other too.

3. 3

   Louisiana keeps the living will and the health care power of attorney as two separate legal instruments under two separate bodies of law, unlike states that combine them. Naming a health care decision-maker in Louisiana means executing a mandate with express health care authority, not adding to this declaration.

4. 4

   Your declaration only takes legal effect once two physicians, one of them your attending physician, certify in writing that you have a terminal and irreversible condition. It is not a general instruction that applies to every hospitalization.

5. 5

   Louisiana's declaration form asks you to choose between withholding all life-sustaining procedures, including nutrition and hydration, or withholding everything except nutrition and hydration. Either way, comfort care and pain relief continue.

6. 6

   You sign in front of two witnesses. Louisiana does not require, or even offer, notarization for this declaration. Both witnesses must be unrelated to you and unable to inherit from your estate.

7. 7

   You can revoke your declaration at any time, regardless of your mental state or competency, by destroying it, by signed writing, or by telling your attending physician.

8. 8

   Louisiana law does not say your declaration has no effect if you are pregnant. It has a narrower rule: if an obstetrician finds the unborn child is far enough along and your life can reasonably be maintained for a live birth, ambiguity in your declaration is read in favor of preserving life once that finding is communicated to the family members and persons designated by law.

9. 9

   Registering your declaration with the Louisiana Secretary of State is optional. It gets you a do-not-resuscitate identification bracelet, but skipping it does not affect your declaration's validity.

Louisiana Requirements for Living Will

• Declaration of Intent (Louisiana Revised Statutes 40:1151 et seq.)

  A clear statement that the document is a declaration under Louisiana's Declarations Concerning Life-Sustaining Procedures law, expressing your wishes about withholding or withdrawing life-sustaining procedures. Louisiana keeps this declaration completely separate from a health care power of attorney; there is no combined instrument.

• Terminal and Irreversible Condition Definition (Louisiana Revised Statutes 40:1151.1)

  Definition of 'terminal and irreversible condition' as a continual profound comatose state with no reasonable chance of recovery, or a condition caused by injury, disease, or illness which, within reasonable medical judgment, would produce death and for which life-sustaining procedures would serve only to postpone the moment of death.

• Life-Sustaining Procedures Definition (Louisiana Revised Statutes 40:1151.1)

  Definition of 'life-sustaining procedure' as any medical procedure or intervention which would serve only to prolong the dying process for a person with a terminal and irreversible condition, expressly including the invasive administration of nutrition and hydration and cardiopulmonary resuscitation. Comfort care measures are expressly excluded from this definition.

• Withholding or Withdrawal of Treatment (Louisiana Revised Statutes 40:1151.2)

  Specific instructions regarding the withholding or withdrawal of life-sustaining procedures once the declarant is certified as having a terminal and irreversible condition.

• Nutrition and Hydration Provisions (Louisiana Revised Statutes 40:1151.2)

  Louisiana's illustrative declaration form builds artificial nutrition and hydration directly into the primary choice rather than folding it silently into a general instruction: the declarant initials either withholding all life-sustaining procedures including nutrition and hydration, or withholding everything except nutrition and hydration.

• Pain Medication and Comfort Care (Louisiana Revised Statutes 40:1151.2)

  The declaration form directs that the declarant be permitted to die naturally with only the administration of medication or medical procedures deemed necessary to provide comfort care, regardless of which life-sustaining-procedure choice is initialed.

• Execution Requirements (Louisiana Revised Statutes 40:1151.2)

  A written declaration must be signed by the declarant in the presence of two witnesses who are not related to the declarant by blood or marriage and who would not be entitled to any portion of the declarant's estate.

• Physician Certification (Louisiana Revised Statutes 40:1151.1, 40:1151.6)

  Two physicians, one of whom must be the attending physician, must diagnose and certify in writing that the declarant has a terminal and irreversible condition before the declarant is a 'qualified patient' and the declaration becomes operative. The attending physician is responsible for ensuring this certification occurs.

• Revocation Procedures (Louisiana Revised Statutes 40:1151.3)

  A declaration may be revoked at any time by the declarant, without regard to mental state or competency, by physical destruction, by signed written revocation, or by oral or nonverbal communication to the attending physician. No witness is required for an oral or nonverbal revocation. If the declaration was registered, revocation must also be filed with the Louisiana Secretary of State.

• Immunity for Healthcare Providers (Louisiana Revised Statutes 40:1151.7)

  Health care providers, physicians, and others acting under a physician's direction who comply in good faith with a properly executed declaration are not subject to criminal prosecution or civil liability for withholding or withdrawing life-sustaining procedures.

• Prohibition Against Euthanasia (Louisiana Revised Statutes 40:1151.9)

  Nothing in the declaration law condones, authorizes, or approves assistance to suicide, mercy killing, or euthanasia. Withholding or withdrawing life-sustaining procedures under a valid declaration is not a suicide and does not affect life insurance coverage.

• HIPAA Authorization (45 CFR Section 164.508)

  Federal HIPAA regulations govern how your protected health information may be disclosed to the family members or persons your declaration identifies, or to anyone you separately authorize under a Louisiana health care mandate. This authorization does not expand or change the treatment-wishes instructions in your declaration itself.

• Patient Self-Determination Act Compliance (42 U.S.C. Section 1395cc(f))

  Federal law requires Medicare- and Medicaid-participating hospitals, nursing homes, and other facilities to inform patients in writing of their right under Louisiana law to make a declaration stating their own treatment wishes.

• Organ Donation Wishes (Louisiana Revised Statutes 17:2351-2359 and 42 U.S.C. Section 274e)

  Louisiana's Anatomical Gift Act, codified in Title 17, lets you express wishes about organ and tissue donation, consistent with the federal National Organ Transplant Act.

• Out-of-State Recognition (Louisiana Revised Statutes 40:1151.9)

  A declaration properly executed under another state's law is deemed validly executed for purposes of Louisiana's declaration law, so a declaration signed elsewhere remains effective if you are later treated in Louisiana.

• Mental Health Treatment Preferences (Louisiana Revised Statutes 28:221-237, Mental Health Advance Directives)

  Louisiana has a separate, voluntary Mental Health Advance Directive law (Revised Statutes 28:221 through 237) letting a person execute a declaration or appoint a representative for behavioral health treatment decisions. This is a separate statute with its own execution rules, distinct from the declaration for life-sustaining procedures.

• Medicare/Medicaid Compliance (42 CFR Section 489.102)

  The declaration and its handling by health care facilities must comply with Medicare and Medicaid conditions of participation regarding advance directives.

• Pregnancy and Ambiguity Interpretation Rule (Louisiana Revised Statutes 40:1151.9(E))

  If the declarant is pregnant, an obstetrician who examines her determines the unborn child's probable postfertilization age is twenty weeks or more, and the pregnant declarant's life can reasonably be maintained in a way that permits the child's continuing development and live birth, Louisiana resolves any ambiguity in the declaration in favor of preserving life, once that determination is communicated to the family members and persons designated in Revised Statutes 40:1151.4. This is not a blanket suspension of the declaration during pregnancy; it is a narrower, conditional interpretive rule.