Do Not Resuscitate Form Louisiana

Living Wills - General - Louisiana

A "declaration" is a witnessed document, statement, or expression voluntarily made by the declarant, authorizing the withholding or withdrawal of life sustaining procedures.  A declaration may be made in writing, orally, or by other means of nonverbal communication. A "life sustaining procedure" is any medical procedure or intervention which would serve only to prolong the dying process for a person diagnosed as having a terminal and irreversible condition. A "life sustaining procedure" does not include any measure deemed necessary to provide comfort care. A "qualified patient" is a patient diagnosed and certified in writing as having a terminal and irreversible condition by two physicians who have personally examined the patient.  One of the two physicians must be the attending physician. A "terminal and irreversible condition" is 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 the application of life sustaining procedures would serve only to postpone the moment of death. Any adult person may, at any time, make a written declaration directing the withholding or withdrawal of life sustaining procedures in the event such person should have a terminal and irreversible condition. A written declaration must be signed by the declarant in the presence of two witnesses. An oral or nonverbal declaration may be made by an adult in the presence of two witnesses by any non-written means of communication at any time subsequent to the diagnosis of a terminal and irreversible condition. If a declaration is oral or nonverbal, the physician must promptly make a recitation of the reasons the declarant could not make a written declaration and make the recitation a part of the patient's medical records. The statutory form is suggested and may include other specific directions including but not limited to a designation of another person to make the treatment decision for the declarant should he be diagnosed as having a terminal and irreversible condition and be comatose, incompetent, or otherwise mentally or physically incapable of communications. A declaration may be revoked at any time by the declarant without regard to his or her mental state or competency by any of the following methods:

(1) By being canceled, defaced, obliterated, burned, torn, or otherwise destroyed by the declarant or by some person in the presence of and at the direction of the declarant. (2) By a written revocation of the declarant expressing the intent to revoke, signed and dated by the declarant. (3) By an oral or nonverbal expression by the declarant of the intent to revoke the declaration.

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