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Content Overview

In Wisconsin, adults have the ability to make their future health care wishes known through the Declaration to Health Care Professionals form, more commonly referred to as a Living Will. This document is a critical tool for stating one's preferences regarding the use of life-sustainment procedures and feeding tubes if they find themselves in a terminal condition or persistent vegetative state. Essential to understanding the gravity and implications of this form is careful reading and comprehension before completion and signing. Central stipulations include the conditions under which medication, life-sustaining procedures, or feeding tubes can be withheld or withdrawn, emphasizing that such decisions must not result in unalleviated pain or discomfort. The document requires witnessing by two adults who meet specific criteria, ensuring the decision is made free from undue influence or conflict of interest. Proper handling of the completed form — keeping it accessible, informing relatives and health care professionals about it, and optionally filing it with the Register in Probate for safekeeping — is crucial. Notably, the form allows for the expression of one's end-of-life care preferences, while clearly stipulating conditions for its revocation and outlining the legal protections afforded to those acting in accordance with its directives. The interplay with other legal health care directives, such as a Power of Attorney for Health Care, is also addressed, highlighting the need for thoughtful consideration in planning one's future health care. Finally, the document enjoins attending health care professionals to honor the declarant's wishes, framing these within legal and ethical boundaries intended to safeguard the dignity and rights of individuals in their most vulnerable moments.

Preview - Wisconsin F 00060 Form

State of Wisconsin

Department of Health Services

The Declaration to Health Care Professionals (Living Will) form makes it possible for adults in Wisconsin to state their preferences for life-sustaining procedures and feeding tubes in the event, the person is in a terminal condition or persistent vegetative state.

Be sure to read both sides of the form carefully, and understand before you complete and sign it.

The withholding or withdrawal of any medication, life-sustaining procedure or feeding tube may not be made if the attending physician, physician assistant, or advanced practice registered nurse advises that doing so will cause pain or reduce comfort, and the pain or discomfort cannot be alleviated through pain relief measures.

Two witnesses are required. Witnesses must be at least 18 years of age, not related to you by blood, marriage or adoption, and not directly financially responsible for your health care. Witnesses may not be persons who know they are entitled to or have a claim on any portion of your estate. A witness cannot be a health care provider who is serving you at the time the document is signed, an employee of the health care provider, other than a chaplain or a social worker, or an employee other than a chaplain or social worker of an inpatient health care facility in which you are a patient. Valid witnesses acting in good faith are immune from civil or criminal liability.

When you have completed and signed the form:

The original signed form should be kept in a safe, easily accessible place until needed.

You should make relatives and friends aware that you have signed the document and the location where it is kept.

A copy of the signed form may be kept on file with your physician, physician assistant, or advanced practice registered nurse. You are responsible for notifying your attending physician, physician assistant, or advanced practice registered nurse of the existence of the Declaration. An attending physician, physician assistant or advanced practice registered nurse who is notified shall make the Declaration part of your medical records.

The document may, but is not required to be, filed for safekeeping, for a fee, with the Register in Probate of your county of residence. The fee for filing with the Register in Probate has been set by State at $8.

A Declaration that is in its original form or is a legible photocopy or electronic facsimile copy is presumed to be valid.

If you have both a Declaration to Health Care Professionals and a Power of Attorney for Health Care, the provisions of a valid Power of Attorney for Health Care supersede any directly conflicting provisions of a valid Declaration to Health Care Professionals.

Up to four copies of the Declaration to Health Care Professionals are available free to anyone who sends a stamped, self-addressed, business-size envelope to Living Will, Division of Public Health, PO Box 2659, Madison, Wisconsin 53701-2659. You may make additional copies of the enclosed blank form. The form is also available on the Department of Health Services Web page https://www.dhs.wisconsin.gov/forms/advdirectives/index.htm.

INSTRUCTIONS FOR DECLARATION TO HEALTH CARE PROFESSIONALS FORM Definitions

“Declaration” means a written, witnessed document voluntarily executed by the declarant under State Statute (1), but is not limited in form or substance to that provided in State Statute 154.03(2).

“Department” means the Department of Health Services.

“Feeding tube” means a medical tube through which nutrition or hydration is administered into the vein, stomach, nose, mouth or other body opening of a qualified patient.

“Terminal condition” means an incurable condition caused by injury or illness that reasonable medical judgment finds would cause death imminently, so that the application of life-sustaining procedures serves only to postpone the moment of death.

“Persistent vegetative state” means a condition that reasonable, medical judgment finds constitutes complete and irreversible loss of all the functions of the cerebral cortex and results in a complete, chronic and irreversible cessation of all cognitive functioning and consciousness and a complete lack of behavioral responses that indicate cognitive functioning, although autonomic functions continue.

“Qualified patient” means a declarant who has been diagnosed, and certified in writing to be afflicted with a terminal condition or to be in a persistent vegetative state by two health care professionals and one of whom is a physician, who have personally examined the declarant.

“Attending health care professional” means a health care professional who has primary responsibility for the treatment and care of the patient.

“Advanced practice registered nurse” means a nurse licensed under ch. 154 who is currently certified by a national certifying body approved by the board of nursing as a nurse practitioner, certified midwife, certified registered nurse anesthetist, or clinical nurse specialist.

“Health care professional” means any of the following: a physician licensed under ch. 154, a physician assistant licensed under ch. 154, or an advanced practice registered nurse.

“Inpatient health care facility” has the meaning provided under State Statute 50.135(1) and includes community-based residential facilities as defined in State Statute 50.01(1g).

“Life-sustaining procedure” means any medical procedure or intervention that, in the judgment of the attending health care professional, would serve only to prolong the dying process but not avert death when applied to a qualified patient.

“Life-sustaining procedure” includes assistance in respiration, artificial maintenance of blood pressure and heart rate, blood transfusion, kidney dialysis and other similar procedures, but does not include (a) the alleviation of pain by administering medication or by performing a medical procedure; or (b) the provision of nutrition or hydration.

Procedures for Signing Declarations

A Declaration must be signed by the declarant in the presence of two witnesses. If the declarant is physically unable to sign a Declaration, the Declaration must be signed in the declarant’s name by one of the witnesses or some other person at the declarant’s express direction and in his or her presence; such a proxy signing shall either take place or be acknowledged by the declarant in the presence of two witnesses.

Effect of Declaration

The desires of a qualified patient who is competent supersede the effect of the Declaration at all times. If a qualified patient is incompetent at the time of the decision to withhold or withdraw life- sustaining procedures or feeding tubes, a Declaration executed under this chapter is presumed to be valid.

Revocation of Declaration

A Declaration may be revoked at any time by the declarant by any of the following methods:

1)By being canceled, defaced, obliterated, burned, torn or otherwise destroyed by the declarant or by some person who is directed by the declarant and who acts in the presence of the declarant.

2)By a written revocation, signed and dated by the declarant expressing the intent to revoke.

3)By a verbal expression by the declarant of his or her intent to revoke the Declaration, but only if the declarant or a person acting on behalf of the declarant notifies the attending physician, physician assistant, or advanced practice registered nurse of the revocation.

4)By executing a subsequent Declaration.

The attending physician, physician assistant, or advanced practice registered nurse shall record in the declarant’s medical records the time, date and place of the revocation and time, date and place, if different, that he or she was notified of the revocation.

Liabilities

No physician, physician assistant, or advanced practice registered nurse, inpatient health

care facility or health care professional acting under direction of a physician, physician assistant, or advanced practice registered nurse may be held criminally or civilly liable, or charged with unprofessional conduct of any of the following:

1)Participating in the withholding or withdrawal of life-sustaining procedures or feeding tubes under Ch. 154, subchapter II.

2)Failing to act upon a revocation unless the person or facility has actual knowledge of therevocation.

3)Failing to comply with a Declaration, except that failure by a physician, physician assistant, or advanced practice registered nurse to comply with a Declaration of a qualified patient constitutes unprofessional conduct if the physician, physician assistant, or advanced practice registered nurse refuses or fails to make a good faith attempt to transfer the patient to another physician, physician assistant, or advanced practice registered nurse who will comply with the Declaration.

F-00060A (Rev. 02/2020)

DEPARTMENT OF HEALTH SERVICES

STATE OF WISCONSIN

Division of Public Health

Effective Date February 7, 2020

F-00060 (02/2020) Page 1 of 2

Wis. Stat. §154.03(1)(2)

PLEASE BE SURE YOU READ THE FORM CAREFULLY AND UNDERSTAND IT

BEFORE YOU COMPLETE AND SIGN IT

DECLARATION TO HEALTH CARE PROFESSIONALS (WISCONSIN LIVING WILL)

I,

being of sound mind, voluntarily state my desire that my dying not be prolonged under the circumstances specified in this document. Under those circumstances, I direct that I be permitted to die naturally. If I am unable to give directions regarding the use of life-sustaining procedures or feeding tubes, I intend that my family and physician, physician assistant or advanced practice registered nurse, honor this document as the final expression of my legal right to refuse medical or surgical treatment.

1.If I have a TERMINAL CONDITION, as determined by a physician, physician assistant, or advanced practice registered nurse, who have personally examined me, and if a physician who has also personally examined me agrees with that determination, I do not want my dying to be artificially prolonged and I do not want life-sustaining procedures to be used. In addition, the following are my directions regarding the use of feeding tubes:

YES, I want feeding tubes used if I have a terminal condition.

NO, I do not want feeding tubes used if I have a terminal condition. If you have not checked either box, feeding tubes will be used.

2.If I am in a PERSISTENT VEGETATIVE STATE, as determined by a physician, physician assistant, or advanced practice registered nurse who have personally examined me, and if a physician who has also personally examined me agrees with that determination, the following are my directions regarding the use of life-sustaining procedures:

YES, I want life-sustaining procedures used if I am in a persistent vegetative state.

NO, I do not want life-sustaining procedures used if I am in a persistent vegetative state. If you have not checked either box, life-sustaining procedures will be used.

3.If I am in a PERSISTENT VEGETATIVE STATE, as determined by a physician, physician assistant, or advanced practice registered nurse who has personally examined me, and if a physician who has also personally examined me agrees with that determination, the following are my directions regarding the use of feeding tubes:

YES, I want feeding tubes used if I am in a persistent vegetative state.

NO, I do not want feeding tubes used if I am in a persistent vegetative state.

If you have not checked either box, feeding tubes will be used.

If you are interested in more information about the significant terms used in this document, see section 154.01 of the Wisconsin Statutes or the information accompanying this document.

F-00060 (02/2020) Page 2 of 2

ATTENTION: You and the 2 witnesses must sign the document at the same time.

Signed

Date

Address

Date of Birth

I believe that the person signing this document is of sound mind. I am an adult and am not related to the person signing this document by blood, marriage or adoption. I am not entitled to and do not have a claim on any portion of the person's estate and am not otherwise restricted by law from being a witness.

Witness Signature_______________________________________Date Signed

Print Name

Witness Signature

Date Signed

Print Name

DIRECTIVES TO ATTENDING PHYSICIAN, PHYSICIAN ASSISTANT,

OR ADVANCED PRACTICE REGISTERED NURSE

1.This document authorizes the withholding or withdrawal of life-sustaining procedures or of feeding tubes when a physician and another physician, physician assistant, or advanced practice registered nurse, one of whom is the attending health care professional, have personally examined and certified in writing that the patient has a terminal condition or is in a persistent vegetative state.

2.The choices in this document were made by a competent adult. Under the law, the patient's stated desires must be followed unless you believe that withholding or withdrawing life- sustaining procedures or feeding tubes would cause the patient pain or reduced comfort and that the pain or discomfort cannot be alleviated through pain relief measures. If the patient's stated desires are that life-sustaining procedures or feeding tubes be used, this directive must be followed.

3.If you feel that you cannot comply with this document, you must make a good faith attempt to transfer the patient to another physician, physician assistant, or advanced practice registered nurse who will comply. Refusal or failure to make a good faith attempt to do so constitutes unprofessional conduct.

4.If you know that the patient is pregnant, this document has no effect during her pregnancy.

* * * * *

The person making this living will may use the following space to record the names of those individuals and health care providers to whom he or she has given copies of this document:

Form Specifications

Fact Name Description
Document Purpose The Wisconsin F 00060 form allows adults in Wisconsin to state their preferences for life-sustaining procedures and feeding tubes if they are in a terminal condition or persistent vegetative state.
Witness Requirement Two witnesses are required for the form to be valid. Witnesses must be at least 18 years old, not related by blood, marriage, or adoption, and not have a financial responsibility for the signer’s healthcare or a claim on their estate.
Witness Immunity Valid witnesses acting in good faith are immune from civil or criminal liability.
Form Accessibility Up to four copies of the Declaration to Health Care Professionals are available free of charge, with additional copies being made by the individual. The form is also accessible on the Department of Health Services Web page.
Governing Law The form and its execution are governed by Wis. Stat. §154.03(1)(2), specifying requirements for living wills in Wisconsin.
Revocation Process A Declaration can be revoked at any time through destruction of the document, a written revocation, a verbal expression of intent to revoke, or by executing a subsequent Declaration.
Relation to Power of Attorney for Health Care If an individual has both a Declaration to Health Care Professionals and a Power of Attorney for Health Care, the provisions of the valid Power of Attorney for Health Care supersede any conflicting provisions of the Declaration.

Detailed Instructions for Using Wisconsin F 00060

Filling out the Wisconsin F 00060 form, officially known as the Declaration to Health Care Professionals or Wisconsin Living Will, is a crucial step in planning for your future health care. This document allows you to express your wishes regarding life-sustaining procedures and feeding tubes in the event that you are in a terminal condition or persistent vegetative state. Understanding and completing this form accurately ensures your health care preferences are known and can be followed by your health care team. Below are the steps to properly complete the form. Your attention to detail is important in each step to ensure your wishes are clearly communicated.

  1. Start by reading the entire form carefully to ensure you understand the terms and conditions described.
  2. Enter your full name at the beginning of the form to affirm your intention to make a declaration regarding your health care treatment preferences.
  3. Review the options provided under each condition (terminal condition and persistent vegetative state) thoroughly. For each condition, decide if you want life-sustaining procedures or feeding tubes used. Mark your choice clearly by checking the appropriate box.
  4. If you do not check a box under any of the conditions, understand that the default decision will be to use life-sustaining procedures or feeding tubes.
  5. After considering your options and making your selections, fill in your signature and the date to validate your declaration. Your address and date of birth must also be provided in the designated areas.
  6. Ensure that two witnesses sign and date the form in the presence of each other and you. Witness signatures are crucial as they affirm the validity of your declaration. Remember, witnesses must not be related to you by blood, marriage, or adoption, have any claim on your estate, or be directly financially responsible for your healthcare. Furthermore, they must be over the age of 18 and should not be healthcare providers currently treating you.
  7. Review the section provided for directives to your attending physician, physician assistant, or advanced practice registered nurse. This section does not require any action on your part but serves as important information for your healthcare providers.
  8. Finally, use the space provided at the end of the document to record the names of individuals and health care providers to whom you have given copies of this document. This step is not required but can be helpful in ensuring that your preferences are known to the relevant parties.

After filling out the form, keep the original in a safe but accessible place and inform your relatives, friends, and health care providers about the document and where it is stored. Remember, this living will reflects your health care preferences and should be an integral part of your medical records. Sharing this information with your attending physician, physician assistant, or advanced practice registered nurse and ensuring it becomes part of your medical records is your responsibility. Your proactive measures today ensure your health care wishes are respected tomorrow.

Listed Questions and Answers

What is the Wisconsin F 00060 form?

The Wisconsin F 00060 form, also known as the Declaration to Health Care Professionals (Living Will), enables adults in Wisconsin to express their preferences regarding the use of life-sustaining procedures and feeding tubes if they find themselves in a terminal condition or persistent vegetative state. It is a critical document that indicates a person's healthcare wishes, ensuring they are respected during times when they might not be able to communicate them personally.

Who can act as a witness for the Wisconsin F 00060 form?

Witnesses must meet several specific criteria: they should be at least 18 years old and not related to the signatory by blood, marriage, or adoption. Furthermore, they cannot be financially responsible for the signatory’s healthcare, have a claim on their estate, or be a healthcare provider or facility employee currently serving the signatory. This includes avoiding chaplains or social workers who are employed by the inpatient facility where the patient is receiving care.

Where should the Wisconsin F 00060 form be kept?

After signing the form, it should be kept in a safe but easily accessible place. It’s important that relatives and friends know about the document and its location. Additionally, giving a copy to your physician, physician assistant, or advanced practice registered nurse is advisable, and you are responsible for informing them about the existence of the Declaration. The document can also be filed with the Register in Probate in your county of residence for a fee, although this is not mandatory.

How can the Wisconsin F 00060 form be revoked?

A declaration can be revoked at any time, in several ways: by physically destroying the document, through a written revocation signed and dated by the declarant, by verbally stating the intent to revoke in front of a healthcare professional, or by creating a subsequent declaration. It is crucial that the attending healthcare professional is informed of the revocation to ensure the patient's medical records are updated accordingly.

What happens if there is a conflict between a Living Will and Power of Attorney for Health Care?

In Wisconsin, if an individual has both a Declaration to Health Care Professionals (Living Will) and a Power of Attorney for Health Care, the provisions of a valid Power of Attorney for Health Care take precedence over any conflicting provisions in a valid Living Will. This ensures that the most recent desires regarding healthcare decisions are followed.

Are there any legal protections for witnesses or healthcare professionals involved with the Wisconsin F 00060 form?

Yes, valid witnesses acting in good faith are immune from civil or criminal liability associated with their role in witnessing the document. Similarly, healthcare professionals who participate in withholding or withdrawing life-sustaining procedures or feeding tubes, act upon a revocation, or fail to comply with a Declaration in specific circumstances are protected from being held criminally or civilly liable, or being charged with unprofessional conduct, provided they act according to the stipulations of the form and state law.

Common mistakes

Completing the Wisconsin F 00060 form, also known as the Declaration to Health Care Professionals or Living Will, is a pivotal step for adults in Wisconsin to express their preferences regarding the use of life-sustaining procedures and feeding tubes in the event they find themselves in a terminal condition or persistent vegetative state. However, despite the comprehensive guidelines provided, individuals often stumble over common pitfalls that can significantly impact the effectiveness of their declaration. Awareness and avoidance of these errors are crucial for ensuring their wishes are honored accurately.

Firstly, failing to properly designate the use of feeding tubes and life-sustaining procedures stands out as a frequent misstep. This declaration offers specific sections to indicate preferences concerning feeding tubes and life-sustaining procedures under distinct circumstances - terminal condition and persistent vegetative state. It's crucial to check the corresponding boxes to articulate one's choice explicitly. Neglecting to make a clear designation could result in default actions being taken that may not align with individual preferences.

Another common mistake is choosing ineligible witnesses for the signing of the document. Witnesses play an integral role in the validity of the Living Will, with strict eligibility criteria set to ensure impartiality. Witnesses must be at least 18 years old and cannot be related by blood, marriage, or adoption, nor can they stand to financially benefit from the death of the declarant, nor be involved in their healthcare provisions at the time of the signing. Overlooking these requirements can render the document legally ineffective.

In the context of notarization and copies, individuals often overlook the importance of keeping the original document accessible and making known its location. While not a direct part of filling out the form, correctly managing the document post-signature is critical. The original signed form should be stored safely but accessibly, with close relatives or decision-makers made aware of its location. Additionally, distributing copies to relevant healthcare providers and considering filing with the Register in Probate for safekeeping are steps that should not be dismissed lightly.

  1. Not properly indicating preferences for life-sustaining procedures and the use of feeding tubes.
  2. Selecting witnesses who do not meet the statutory eligibility criteria.
  3. Failing to discuss and share the completed document with family members and healthcare providers.
  4. Neglecting to consider the registration of the document with the Register in Probate for added legal safeguarding.

The successful creation of a Living Will through the Wisconsin F 00060 form mandates attentiveness to detail and an understanding of the legal requirements. Avoiding the common mistakes outlined above is key to formulating a document that faithfully represents one's healthcare preferences and ensures peace of mind for both the individual and their loved ones.

Documents used along the form

When an individual in Wisconsin decides to fill out the F 00060 form, also known as the Declaration to Health Care Professionals (Living Will), it's usually not the only document they'll need to ensure their healthcare desires are respected. This vital form helps express choices about life-sustaining treatments and feeding tubes, but several other documents can play crucial roles in planning for future health care needs and ensuring one's wishes are known and respected. Here is a list of additional forms and documents often used along with the Wisconsin F 00060 form:

  • Power of Attorney for Health Care: This document allows an individual to designate another person (an agent) to make health care decisions on their behalf if they become unable to do so. It covers more general health care decisions than the F 00060, and its provisions supersede the living will if there is a conflict.
  • Do Not Resuscitate (DNR) Order: A medical order signed by a doctor stating that in the event of a cardiac or respiratory arrest, resuscitation measures should not be attempted. This document is used by those who want to avoid aggressive measures meant to revive them.
  • HIPAA Release Form: The Health Insurance Portability and Accountability Act (HIPAA) privacy rule protects patients' medical records and other health information. This form allows individuals to give written permission for their health information to be disclosed to specific people.
  • Organ and Tissue Donor Form: Specifies an individual's wishes regarding organ and tissue donation at the time of death. It can be part of a driver's license or state ID process or done through an online registry.
  • Advance Directive for Mental Health Treatment: Similar to a living will, but specifically directed towards decisions about mental health treatment options, including preferences for medications, counseling, hospitalization, and electroconvulsive therapy.
  • Declaration of Preneed Guardian: Allows individuals to declare who they want to be appointed as their guardian in case they become incapacitated and unable to make decisions for themselves.
  • Funeral Planning Declaration: Enables individuals to specify arrangements for their funeral, cremation, burial, or other final arrangements. This can help ensure that one’s final wishes are respected and can relieve some of the decision-making burdens from loved ones.
  • Financial Power of Attorney: A legal document that gives another person the authority to handle financial transactions on an individual's behalf. While not directly related to healthcare, it's an essential part of planning for incapacity.

Filling out the F 00060 form and accompanying documents requires careful thought and often, discussions with loved ones and healthcare providers. It's also advisable to seek legal advice to ensure all forms accurately reflect the individual's wishes and are properly executed. Together, these documents can provide comprehensive guidance to healthcare providers and relieve family members from the pressure of making critical decisions during stressful times.

Similar forms

The Health Care Power of Attorney (HCPOA) form closely resembles the Wisconsin F 00060 Living Will by allowing individuals to specify their preferences regarding medical treatment and care. Like the Living Will, the HCPOA enables adults to plan how their health care decisions should be made in the event they become unable to communicate their wishes. Both documents require individuals to clearly state their medical treatment preferences, yet the HCPOA notably differs by designating another individual, the agent, to make health care decisions on behalf of the person, providing a broader scope of decision-making power beyond the specific circumstances of terminal illness or persistent vegetative state.

Do Not Resuscitate (DNR) orders are another comparable document which, like the Living Will, specify an individual's preferences regarding Life-sustaining procedures. DNR orders are specifically aimed at preventing emergency medical personnel from performing cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. Although both the Living Will and DNR orders guide healthcare professionals during critical moments, DNR orders are more narrowly focused on the avoidance of resuscitation efforts rather than the broader scope of medical interventions addressed in a Living Will.

An Advance Directive is a comprehensive term that encompasses various types of health care directives, including Living Wills and Health Care Powers of Attorney. It serves as a written statement of a person's wishes regarding medical treatment when they are no longer able to communicate these due to illness or incapacity. Similar to the Wisconsin F 00060 form, Advance Directives are tools for planning for future health care and can define in extensive detail the types of medical care and life-sustaining treatments an individual wishes to receive or avoid.

The Physician Orders for Life-Sustaining Treatment (POLST) form is a medical order that outlines a terminally ill patient’s preferences regarding life-sustaining medical treatments. Like the Living Will, it is designed to ensure that a patient’s wishes are followed by health care providers during critical or terminal phases of illness. However, the POLST form is considered complementary to a Living Will because it is more medically detailed and immediately actionable by medical personnel.

A Mental Health Advance Directive allows individuals to specify their preferences for mental health treatment, much like how a Living Will specifies preferences for medical treatment in terminal or vegetative states. While addressing a different aspect of health care—mental health, as opposed to physical health care decisions—both documents serve the crucial role of guiding health care providers when the individual is unable to make decisions due to incapacitation.

The Five Wishes document is another form of an Advance Directive that provides a comprehensive approach to discussing and documenting one’s care preferences in detailed personal, emotional, and spiritual terms in addition to medical wishes. It extends beyond the focus of the Living Will by addressing comfort care, dignity, forgiveness, and saying goodbye, providing a holistic approach to end-of-life planning. Although similar in their objectives to ensure that one’s preferences are respected, the Living Will is more specific in its legal scope within Wisconsin’s statute.

A Posthumous Health Care Directive is somewhat akin to a Living Will, with its purpose being to instruct on the handling of an individual's body and health care decisions after death, such as organ donation preferences. While the focus is on post-mortem care rather than decisions made during life, both documents enable an individual to plan ahead and make personal health care decisions that are respected by health care providers and family members alike.

A Guardianship Appointment is a legal document that can complement a Living Will by appointing someone to make decisions on behalf of an individual if they become unable to do so themselves, encompassing a wide range of decisions beyond health care. While a Living Will precisely declares health care wishes in specific situations, a Guardianship Appointment provides a legal mechanism for everyday decision-making power, including but not limited to health care.

The Organ Donor Registry form allows individuals to make specific decisions regarding organ and tissue donation after death. Similar to a Living Will’s capacity to dictate certain aspects of one’s medical treatment preferences at end-of-life, the Organ Donor Registry conveys wishes pertaining to organ donation, ensuring such preferences are known and can be acted upon promptly at the time of death.

A Declaration for Mental Health Treatment, specifically addressing mental health crisis care, is similar to a Living Will insofar as it documents an individual's treatment preferences when they cannot make decisions for themselves. Although focused on psychiatric rather than physical health crises, it parallels the Living Will's function by guiding healthcare providers through an individual’s predefined decisions regarding their care during incapacity.

Dos and Don'ts

Filling out the Wisconsin F 00060 form, a Declaration to Health Care Professionals (Living Will), requires careful attention to detail and understanding of its implications. It is crucial to approach this task thoughtfully, as it pertains to decisions about life-sustaining procedures and feeding tubes under specific medical conditions. Here are four key dos and don'ts to keep in mind:

  • Do thoroughly read and understand both sides of the form before filling it out. This ensures that you are fully informed about what the declaration entails and how it will affect your future medical care under certain conditions.
  • Do discuss your intentions with relatives and friends. After completing and signing the form, it's important to inform your loved ones about the existence of this document and its location. This facilitates its use when needed.
  • Do choose your witnesses carefully. Witnesses must be at least 18 years old, not related by blood, marriage, or adoption, and must not have a direct financial responsibility for your healthcare. They should also not stand to inherit any portion of your estate or be your healthcare provider or an employee of a healthcare facility where you are receiving care.
  • Do notify your attending physician, physician assistant, or advanced practice registered nurse of the existence of the Declaration. Ensure this document becomes part of your medical records by informing your primary healthcare professional.
  • Don't rush through the process. Take your time to consider your choices about life-sustaining procedures and feeding tubes, especially in situations like a terminal condition or persistent vegetative state.
  • Don't choose witnesses who are disqualified. Avoid selecting witnesses who are related to you, who might have a financial interest in your healthcare, or who are healthcare providers currently serving you. This ensures the legal validity of their witness.
  • Don't leave the form in a place where it cannot be easily accessed. After signing the form, store it in a safe, easily accessible location and inform your family and healthcare provider about where it is kept.
  • Don't forget to consider the need for copies. Although the original signed form should be kept safe, creating copies for your physician, advanced practice registered nurse, or to be filed for safekeeping with the Register in Probate of your county of residence can be crucial. Remember, you are responsible for a small fee if you choose to file it with the Register in Probate.

Misconceptions

When it comes to the Wisconsin F 00060 form, or the Declaration to Health Care Professionals (Living Will), there are several misconceptions that often come up. Understanding what this document is and what it isn't can help you make informed decisions about your healthcare preferences in critical situations.

  • Only for the Elderly: A common misconception is that this document is only for the elderly. In reality, it's a crucial document for adults of any age, as it specifies your preferences for life-sustaining procedures and feeding tubes in case you are unable to communicate your decisions due to a terminal condition or a persistent vegetative state.

  • Legally Binding Immediately After Signing: Some believe that simply signing the form is enough to make it legally binding. However, the form must be witnessed by two individuals who meet specific criteria outlined in the form to be considered valid.

  • Witness Restrictions: There's a misunderstanding that anyone can witness the document. Witnesses must be adults, not related by blood, marriage, or adoption, have no financial interest in your estate, and cannot be your healthcare provider or an employee of a healthcare facility where you are receiving care.

  • It Prevents All Medical Treatment: Another misconception is that the declaration prevents all medical treatment. Instead, it allows adults to state their preferences for life-sustaining procedures and feeding tubes but does not refuse other forms of care, such as pain relief measures.

  • Difficult to Revoke: People often think once the declaration is made, it cannot be easily revoked. In truth, the declaration can be revoked at any time in several ways, including verbally, by destroying the document, through a written revocation signed and dated, or by creating a new declaration.

  • Automatically Shared with Healthcare Providers: There's a belief that once the declaration is signed, healthcare providers automatically know about it. Actually, the responsibility to inform healthcare professionals about the declaration rests with the individual or their family.

  • Supersedes Power of Attorney for Healthcare: Some assume this declaration overrides a Power of Attorney for Health Care. However, if you have both documents and they conflict, the Power of Attorney for Health Care's provisions take precedence over the living will's instructions.

  • Cost Prohibitive: The misconception that obtaining or filing the form is expensive prevents some from completing it. While there is an $8 fee to file the document for safekeeping with the Register in Probate, the form itself is available for free from the state's Department of Health Services website.

  • Difficult to Obtain: People often believe that the form is difficult to obtain. The truth is, up to four copies of the Declaration to Health Care Professionals are available for free, and additional copies can be made. The form is also easily accessible on the Department of Health Services website.

  • One-Time Decision: Lastly, many perceive the declaration as a one-time decision that cannot be adjusted. Preferences and situations change, and so can your living will. Updating your declaration as your healthcare outlook or wishes change is not only possible but advisable.

Understanding these misconceptions can help clarify the intent and the flexibility of the Wisconsin F 00060 form, ensuring that your healthcare preferences are respected when it matters most.

Key takeaways

Completing the Wisconsin F 00060 form, known as the Declaration to Health Care Professionals (Living Will), allows adults in Wisconsin to declare their preferences regarding life-sustaining procedures and the use of feeding tubes if they find themselves in a terminal condition or in a persistent vegetative state. To ensure their wishes are honored, individuals must first understand, complete, and correctly sign this document. Here are five key takeaways about filling out and using the Wisconsin F 00060 form:

  • Requirements for Completing the Form: The form necessitates careful reading and understanding before it is completed and signed. It is essential as it contains critical choices about life-sustaining treatments and end-of-life care preferences.
  • Witness Guidelines: Signing of the form must be observed by two qualified witnesses who are at least 18 years old. These witnesses cannot be related by blood, marriage, or adoption, have financial responsibility for the signer's healthcare, or be entitled to any part of the signer’s estate.
  • Storage and Sharing of the Form: After signing, the original document should be stored in a secure yet accessible location. It is advisable to inform close relatives and friends about the existence and location of the form. Copies should also be shared with the individual's attending physician, physician assistant, or advanced practice registered nurse to make it part of the medical records.
  • Revocation Process: The declarant can revoke the Living Will at any time using several methods, such as physical destruction of the document, a written revocation, a verbal expression of intent to revoke conveyed to the medical provider, or by completing a new Declaration.
  • Legal Protections and Obligations: The form also outlines legal protections for health care providers who follow the directive in good faith and specifies the process for health care providers if they cannot comply with the directive, including making a good faith attempt to transfer the patient to another provider that will comply.

Understanding and accurately completing the Wisconsin F 00060 form ensures individuals can have their healthcare preferences understood and respected, even if they are not able to communicate them directly due to their medical condition. Ensuring all requirements are met, including proper witness signatures, can provide peace of mind to individuals and their families that their wishes will be honored.

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