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Life comes with its uncertainties, and it's important to be prepared for the unforeseen. In Indiana, individuals have the means to express their wishes regarding medical treatment through the Indiana Living Will form. This essential document allows a person to outline specifically what medical actions should be taken if they're unable to make decisions for themselves due to serious illness or incapacitation. It acts as a guide for family members and healthcare professionals, ensuring that the person's wishes regarding life-sustaining treatments, resuscitation, and other critical healthcare decisions are known and respected. The form covers various scenarios, including the use of artificial life support systems, feeding tubes, and other means of prolonging life. Completing this document is a proactive step that can spare families the emotional burden of guessing what their loved ones would have wanted in dire situations. It also plays a crucial role in medical and legal contexts by providing clear instructions that healthcare providers can follow, honoring the individual's autonomy and preferences in their healthcare.

Sample - Indiana Living Will Form

This Living Will Declaration is specifically tailored to comply with the Indiana Living Will and Life Prolonging Procedures Act. It allows individuals to outline their preferences for medical treatment should they become unable to communicate their medical care decisions due to a terminal condition.

Personal Information

Name: ________________________________________

Date of Birth: _______________________________

Address: _____________________________________

City: _______________ State: IN Zip: __________

Living Will Declaration Statement

I, _________________________(the "Declarant"), being of sound mind, willfully and voluntarily make known my desire that my dying shall not be artificially prolonged under the circumstances set forth below. I understand that this may involve withholding or withdrawal of life-sustaining procedures or the provision of medically appropriate and necessary pain relief, even if it hastens my death. I am fully informed as to the nature of a living will and I understand the full import of this declaration.

Life-Prolonging Procedures Direction

If at any time I should have an incurable injury, disease, or illness certified to be a terminal condition by two physicians, where the application of life-prolonging procedures would serve only to artificially prolong the dying process, I direct that such procedures be withheld or withdrawn, and that I be permitted to die naturally with only the administration of medication or the performance of any medical procedure deemed necessary to provide me with comfortable care or to alleviate pain.

Artificial Nutrition and Hydration Directive

□ I direct that nutrition and hydration (fluids) be withheld or withdrawn from me in any event, even if the withholding or withdrawal of artificial nutrition and hydration serves to hasten my death.

□ I desire that I be provided with nutrition and hydration (fluids), even if the administration of such artificially prolongs my life and my dying process.

Authorization and Signature

This Living Will Declaration reflects my firm and settled commitment to refuse life-prolonging treatment under the conditions described herein. I urge all concerned to comply with my directive and ask that my family, doctors, and health care providers honor my wishes as stated in this declaration.

Date: _____________

Signature of Declarant: __________________________

Witness Statement

We declare that the Declarant is personally known to us, that the Declarant signed or acknowledged this Indiana Living Will Declaration in our presence, that the Declarant appears to be of sound mind and not under duress, fraud, or undue influence, that we are not the Declarant’s attending physician, not related to the Declarant by blood or marriage, and not entitled to any part of the Declarant’s estate upon their decease under a will now existing or by operation of law.

Witness 1 Signature: __________________________ Date: _____________

Witness 2 Signature: __________________________ Date: _____________

State of Indiana

County of _____________

On this day, ____________, before me, _____________________ (Notary Public), personally appeared _______________________ (Declarant) and ________________________ and ________________________ (witnesses), known to me to be the individuals described in and who executed the foregoing document, and acknowledged that they executed the same as their free act and deed.

Notary Signature: __________________________

My Commission Expires: ______________

PDF Form Information

Fact Description
1. Purpose The Indiana Living Will form is intended to allow individuals to outline their preferences for medical treatment should they become unable to make decisions for themselves.
2. Applicable Law It is governed by the Indiana Code 16-36-4 (Life Prolonging Procedures Act).
3. Key Components It typically includes instructions on the use of life-sustaining treatment, artificial nutrition and hydration, and end-of-life care preferences.
4. Eligibility To execute a Living Will in Indiana, an individual must be at least 18 years old and of sound mind.
5. Witnesses The Living Will must be signed by the declarant in the presence of two witnesses, who also need to sign the document.
6. Witness Restrictions Witnesses cannot be related to the declarant by blood or marriage, entitled to any portion of the declarant’s estate, or directly responsible for the declarant’s medical care.
7. Revocation The Living Will can be revoked at any time by the declarant through a written, dated statement; destroying the document; or orally informing the attending physician or other healthcare provider.

How to Write Indiana Living Will

A Living Will is a legal document allowing individuals to outline their wishes regarding medical treatment in the event they become unable to communicate their decisions. It is an important step in planning for future healthcare needs. Once the decision to complete a Living Will has been made, the process in Indiana involves a few specific steps to ensure the document is legally valid and reflects the wishes of the individual accurately.

  1. Obtain the official Indiana Living Will form. This can be done by downloading it from the Indiana State Department of Health website or requesting a copy from a healthcare provider.
  2. Read the form carefully to understand what types of decisions can be made regarding medical treatment and life-prolonging measures.
  3. Decide on your wishes regarding the acceptance or refusal of life-prolonging measures in the event that you are diagnosed with an incurable injury, disease, or illness.
  4. Fill in your personal information on the form, including your full name, date of birth, and address. This information helps to identify you and ensures that the Living Will is applied to your medical decisions.
  5. Indicate your specific wishes regarding the use of life-prolonging measures, artificial nutrition, and hydration. Be as clear and detailed as possible to ensure your healthcare providers understand your preferences.
  6. Sign the form in the presence of two witnesses who are at least 18 years of age. The witnesses cannot be individuals who are related to you, entitled to any part of your estate, directly financially responsible for your medical care, or involved in providing your healthcare. This rule helps to maintain the impartiality of the witnesses.
  7. Have the witnesses sign the form, confirming they have witnessed your signature and that you are voluntarily signing the document.
  8. Consider giving copies of the completed Living Will to your family members, close friends, healthcare providers, and anyone else involved in your healthcare. Keep the original document in a safe place where it can be easily accessed if needed.

Completing a Living Will is a forward-thinking step that relieves family members and healthcare providers from making difficult decisions during stressful times. It ensures your healthcare preferences are respected, even when you may not be able to communicate them yourself.

Key Details about Indiana Living Will

What is an Indiana Living Will?

An Indiana Living Will is a legal document that allows you to express your wishes about medical treatment in the event you are unable to communicate these wishes yourself. This could happen if you become terminally ill or are in a permanently unconscious state.

Who can create a Living Will in Indiana?

Any person who is 18 years of age or older and of sound mind can create a Living Will in Indiana. This means you must understand what a Living Will is and its implications for your healthcare.

How do I create a Living Will in Indiana?

To create a Living Will in Indiana, you need to complete the Living Will Declaration form. This form must be signed in the presence of a witness or a notary public. The witness cannot be anyone who is related to you by blood or marriage, entitled to any part of your estate, or directly responsible for your medical costs.

What decisions can I make in my Indiana Living Will?

Your Indiana Living Will allows you to make decisions about the use of life-prolonging measures, such as mechanical ventilation, tube feeding, or resuscitation. You can specify what treatments you do or do not want. You can also appoint a healthcare representative to make these decisions on your behalf if you are unable to do so.

Is an Indiana Living Will different from a Power of Attorney?

Yes, an Indiana Living Will and a Healthcare Power of Attorney serve different purposes, though they both relate to decisions about your healthcare. A Living Will expresses your wishes regarding life-prolonging treatments. In contrast, a Healthcare Power of Attorney allows you to designate someone to make healthcare decisions for you if you cannot. You can have both documents to cover different aspects of your healthcare decisions.

What happens if I change my mind after creating a Living Will?

You can change or revoke your Indiana Living Will at any time, as long as you are of sound mind. You can do this by creating a new Living Will or by physically destroying the existing one. It’s also a good idea to inform your healthcare representative and healthcare providers if you've changed your wishes.

Is a Living Will from another state valid in Indiana?

Indiana law may recognize a Living Will created in another state if it complies with Indiana's legal requirements. However, it's wise to create a new Living Will specific to Indiana to ensure your wishes are followed according to state law.

Common mistakes

The Indiana Living Will form is a legal document that allows individuals to outline their healthcare preferences in the event that they are unable to communicate their wishes. When filling out this important form, several common mistakes can create confusion or lead to unintended results. Here are four errors to avoid:

  1. Not being specific about medical treatments. Many individuals fill out their Living Will with broad statements about their healthcare preferences, without delving into specifics about treatments they would or would not want in various scenarios. This lack of detail can leave healthcare providers and loved ones uncertain about how to proceed in complex medical situations.

  2. Failing to update the document. Life circumstances and medical advancements change over time. An individual's healthcare preferences might evolve due to new diagnoses, changes in health status, or shifts in personal beliefs. However, people often forget to update their Living Will to reflect these changes, potentially leading to care that is incongruent with their current wishes.

  3. Not discussing the document with healthcare providers and loved ones. Simply filling out a Living Will is not enough. It’s vital to have conversations with healthcare providers and family members about the specifics of the document. These discussions ensure that everyone involved understands the individual's desires and is prepared to honor them, reducing the likelihood of disputes or confusion during a crisis.

  4. Improper signing and documentation. A Living Will needs to be properly signed and witnessed or notarized, depending on state requirements. In Indiana, specific legal procedures must be followed for the document to be considered valid. Neglecting these formalities can lead to a situation where the Living Will is not legally recognized, undermining the individual's intentions for their healthcare.

Avoiding these mistakes requires careful consideration and planning. By being specific about medical treatments, regularly updating the document, discussing it with healthcare providers and loved ones, and ensuring it is properly signed and documented, individuals can have greater confidence that their healthcare preferences will be honored.

Documents used along the form

In the context of planning for future health care decisions, the Indiana Living Will form is just one of several documents individuals might consider. This legal document allows a person to outline their preferences for medical treatment should they become unable to communicate their wishes due to illness or incapacity. However, to ensure a more comprehensive approach to health care planning, several other forms and documents are typically used alongside the Indiana Living Will. Each of these serves a distinct but complementary purpose, working together to provide clarity and direction for managing an individual’s health care and personal affairs in times of uncertainty.

  • Health Care Power of Attorney – This vital document grants a designated agent the authority to make healthcare decisions on behalf of the individual if they are incapacitated and unable to make decisions for themselves. It covers a broader range of decisions than a living will, including treatment options not specified in the living will.
  • Physician Orders for Scope of Treatment (POST) Form – Specifically designed for individuals with serious health conditions, the POST form complements a living will by providing physicians with orders regarding the patient’s preferences for life-sustaining treatments, including resuscitation, intubation, and mechanical ventilation.
  • Durable Power of Attorney for Finances – While not directly related to health care decisions, this document is crucial in a comprehensive planning strategy. It allows an individual to designate someone to manage their financial affairs if they become incapacitated, ensuring that bills, investments, and other financial matters are handled according to their wishes.
  • HIPAA Authorization Form – This form allows specified individuals to have access to the person’s medical records and information. It’s important for health care proxies and family members who need to make informed decisions about the individual’s health care or need to discuss the individual’s condition and treatment options with medical providers.

While the Indiana Living Will is a key document for expressing end-of-life care preferences, the combination of these additional forms provides a framework for a comprehensive health care directive plan. Together, they ensure that both health care and financial matters are managed according to the individual's wishes, offering peace of mind to both the individual and their loved ones during difficult times. Consequently, individuals are encouraged to consider all of these documents when planning for future health care and personal affairs management.

Similar forms

The Indiana Living Will is akin to a Medical Power of Attorney document in that both serve to convey an individual's preferences regarding medical treatment. A Medical Power of Attorney specifically allows an individual to appoint another person, typically a trusted friend or family member, to make healthcare decisions on their behalf when they're unable to communicate those decisions themselves. The core similarity lies in their mutual objective to uphold the healthcare wishes of the individual, yet the Medical Power of Attorney focuses on appointing a decision-maker, whereas a Living Will traditionally emphasizes specific medical treatments and interventions the individual does or does not want to receive.

Similarly, the Healthcare Proxy is another document that shares common ground with the Indiana Living Will by appointing an agent to make healthcare decisions. The distinction, however, is often found in the scope of power granted. While the Healthcare Proxy empowers someone to make a wide range of health-related decisions on another's behalf, a Living Will typically documents specific wishes about end-of-life care, such as life support and pain management preferences. Both documents work together to ensure that healthcare decisions reflect the patient's values and desires when they can't speak for themselves.

A Durable Power of Attorney for Health Care is closely related to the Indiana Living Will as well. This document combines elements of both a Medical Power of Attorney and a Healthcare Proxy by allowing an individual to name a healthcare agent who has the authority to make healthcare decisions on their behalf, and it remains in effect even when the individual becomes incapacitated. It differs slightly in that it can include broader powers beyond just health care decisions, depending on how it's written, but like a Living Will, it's integral in planning for future healthcare and ensuring wishes are respected.

An Advance Directive is an overarching term that often includes the Living Will among other documents like the Medical Power of Attorney and Durable Power of Attorney for Health Care. It's designed to provide comprehensive instructions on an individual's preferences for medical treatment and decision-making authority in case they become unable to communicate those wishes directly. Think of an Advance Directive as a package that could contain a Living Will as one of its components, thereby emphasizing a broader preparatory approach to managing healthcare decisions.

The Five Wishes Document brings a unique perspective by extending beyond traditional healthcare directives. It addresses personal, spiritual, and emotional wishes along with medical desires, making it a more holistic approach to end-of-life planning. While it includes aspects similar to those found in a Living Will, such as medical treatment preferences and life support decisions, it also encompasses wishes about the individual's comfort, the type of care they receive, and how they want to be remembered, offering a more comprehensive reflection on one’s end-of-life care.

The POLST (Physician Orders for Life-Sustaining Treatment) form is specifically designed to ensure that seriously ill or frail patients can have their treatment preferences followed by healthcare providers. Unlike a Living Will, which provides general instructions for future treatment preferences, a POLST form translates these wishes into actionable medical orders for current care. It's typically used in conjunction with a Living Will, serving individuals in late stages of illness to ensure that emergency medical personnel and other healthcare providers follow their specific treatment preferences closely.

Dos and Don'ts

When filling out an Indiana Living Will form, it is essential to follow certain guidelines to ensure that the document accurately reflects your wishes and complies with state law. Below are six things you should do and six things you shouldn't do when completing your Living Will.

Do:
  • Read the entire form carefully before you start filling it out to understand all the provisions and how they apply to your situation.
  • Use clear and concise language to express your wishes regarding medical treatment and life-sustaining measures.
  • Discuss your wishes with your family members and healthcare provider to ensure they understand your preferences.
  • Have the document witnessed as required by Indiana law, which usually means having it signed by two adult witnesses who are not your healthcare providers or related to you.
  • Keep the original document in a safe but accessible place, and inform your healthcare proxy, family members, and healthcare provider of its location.
  • Review and update your Living Will regularly, especially after significant life events or changes in your health status.
Don't:
  • Leave any sections blank. If a section does not apply to you, write "N/A" (not applicable) to indicate that you have read and considered it.
  • Use ambiguous language that could be open to interpretation or confusion. Be as specific as possible about your wishes.
  • Forget to date and sign the form once completed, as an undated or unsigned Living Will may not be legally valid.
  • Overlook the need to communicate your wishes and the existence of your Living Will to your healthcare proxy, if you have appointed one.
  • Assume that a Living Will made in Indiana will automatically be recognized in other states. If you spend a lot of time in another state, consider making a separate living will that complures with that state's laws.
  • Ignore state-specific requirements or updates to the law. Always use the most current form and follow the latest guidelines when completing your Living Will.

Misconceptions

When it comes to preparing for the future, understanding the tools available is crucial. The Indiana Living Will form is one such document that often faces misunderstandings. Here are six misconceptions that need clarifying:

  • A Living Will is the same as a Last Will and Testament. This is a common misconception. A Living Will focuses on health care preferences if you become unable to make decisions for yourself. In contrast, a Last Will and Testament deals with the distribution of your assets after your death.

  • Once you create it, you cannot change an Indiana Living Will. This is not true. You have the right to revise or revoke your Living Will at any time, provided you are mentally competent. Life changes, and so can your health care wishes.

  • Doctors will always follow the instructions in a Living Will. While health care providers generally strive to respect your wishes, there can be circumstances where they might not follow your Living Will to the letter. This can occur if your instructions are not clear, or if the medical circumstances are different from what was anticipated.

  • An Indiana Living Will is only for the elderly or the terminally ill. Health emergencies can happen at any age, making it important for adults of all ages to consider their health care preferences. A Living Will speaks for you when you cannot, regardless of your age or current health status.

  • Creating a Living Will means you'll receive less medical care. This is a misunderstanding. A Living Will provides instructions for specific situations, such as if you are in a persistent vegetative state or terminally ill. It does not mean that you'll receive less care in other medical situations. Your wishes for more or less intervention are respected based on what you specify.

  • You need a lawyer to create a Living Will in Indiana. While consulting with a healthcare attorney can provide valuable insight, Indiana law does not require a lawyer to draft a Living Will. Forms are available that meet legal requirements, allowing you to create a Living Will on your own or with minimal assistance.

Key takeaways

When considering filling out the Indiana Living Will form, it's essential to understand its purpose and the specifics that come along with it. Here are the key takeaways to keep in mind:

  • Understanding the purpose: The Indiana Living Will form allows individuals to outline their preferences for medical treatment in the event they become unable to communicate their wishes directly.
  • Eligibility: To fill out the form, you must be at least 18 years old, of sound mind, and acting of your own free will without undue influence from others.
  • Choosing an agent: Though not mandatory, it's advised to designate a health care representative. This person can make medical decisions on your behalf, ensuring your wishes are honored if you're unable to speak for yourself.
  • Specifying conditions: Clearly indicate under which health conditions your living will should take effect. Typically, this applies when recovery is not expected, and you are unable to communicate your desires regarding treatment.
  • Detailing treatment preferences: Articulate your wishes about specific treatments, such as life-prolonging measures, pain management, and organ donation preferences.
  • Signature requirements: Your living will must be signed in the presence of a witness or a notary to be legally binding. The witness cannot be the person you've named as your health care representative.
  • Witness qualifications: The witness to your Indiana Living Will must be at least 18 years old and should not be a relative, heir, or anyone directly involved in your healthcare. This ensures impartiality and reduces the risk of conflicts of interest.
  • Distribution: After completing the form, distribute copies to your health care representative, family members, and physicians. Keep the original in a safe but accessible place. Sharing your living will ensures your healthcare providers and loved ones are aware of your wishes.
  • Review and update: Life circumstances change, and so might your health care preferences. Review your living will periodically and update it as necessary to reflect your current wishes. Remember, you can revoke or change your living will at any time.

Approaching end-of-life planning is a significant task, but by keeping these key points in mind, you can ensure your health care wishes are clearly communicated and respected. The Indiana Living Will form is a tool that empowers you to have a say in your future medical treatment, providing peace of mind for you and your loved ones.

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