The Living Will Declaration Form serves as a crucial advance directive document in South Africa's healthcare and legal framework. While not statutorily regulated, it is recognized under common law and professional medical guidelines. This document becomes particularly important in situations where individuals may lose their capacity to make or communicate healthcare decisions. The Living Will Declaration Form typically includes specific medical treatment preferences, appointment of healthcare proxies, and end-of-life care instructions. It's designed to provide clarity to healthcare providers, family members, and other relevant parties about an individual's healthcare wishes when they cannot express them directly. The document should be prepared while the declarant is of sound mind and should be regularly reviewed and updated to reflect current wishes and circumstances.
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1. Declaration and Personal Details: Identifies the declarant with full legal name, ID number, address, and date of birth
2. Statement of Mental Capacity: Declarant's affirmation of being of sound mind and making the declaration voluntarily
3. General Directive: Overall statement of wishes regarding life-sustaining treatment in case of terminal illness or permanent unconsciousness
4. Specific Medical Directives: Detailed instructions regarding specific medical treatments and interventions (e.g., artificial nutrition, ventilation, resuscitation)
5. Pain Relief and Palliative Care: Explicit wishes regarding pain management and comfort care
6. Designation of Healthcare Proxy: Appointment of a person to make medical decisions if the declarant becomes incapacitated
7. Execution and Witnesses: Signature section with space for declarant and witnesses' signatures, dates, and details
1. Organ Donation Wishes: Optional section for specifying wishes regarding organ donation after death
2. Religious or Cultural Preferences: Section for specifying any religious or cultural considerations that should be respected in end-of-life care
3. Alternative Healthcare Proxy: Designation of an alternative proxy in case the primary proxy is unavailable
4. Pregnancy Provision: For female declarants who wish to specify different instructions if pregnant at the time the living will comes into effect
5. Specific Medical Conditions: Additional instructions relating to existing medical conditions or specific scenarios
1. Medical Conditions Schedule: Detailed list of any pre-existing medical conditions and current medications
2. Contact Information Appendix: Complete contact details for healthcare proxy, alternative proxy, primary physician, and family members to be notified
3. Distribution List: List of persons and institutions to receive copies of the Living Will (e.g., family doctor, hospital, healthcare proxy)
4. Glossary of Medical Terms: Definitions of medical terms used in the document for clarity
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