(If you want to limit the authority of your agent to make healthcare decisions for you, you can state the limitations in paragraph (4) ("Statement of Desires, Special Provisions, and Limitations") below. You can indicate your desires by including a statement of your desires in the same paragraph.)
Full Answer
LIMITATIONS ON THE DECISION-MAKING AUTHORITY OF MY AGENT ARE AS FOLLOWS:My Directive to Physicians executed on even date herewith shall control over this document as to the decision to withdraw or withhold life support systems. Designation of Alternate Agent. (You are not required to designate an alternate agent, but you may do so.
make health care decisions on my behalf, my health care agent: (Initials) shall NOT have the authority to withhold artificial nutrition (such as through tubes) OR may exercise that authority only in accordance with the following special provisions: (Initials) shall NOT have the authority to withhold artificial hydration (such as through
a. Initialing at line 11 to limit this power of attorney to health care decisions at Southwest Washington Medical Center including discharge decisions; or b. Initialing at line 16 to grant unlimited authority to your attorney-in-fact regarding health care decisions. Do not initial both lines 11 and 16. 4.
as my attorney in fact (agent) to make health care decisions for me as authorized in this document. For the purposes of this document, "health care decision" means consent, refusal of consent, or withdrawal of consent to any care, treatment, service, or procedure to maintain, diagnose, or treat an individual's physical or mental condition. 2.
A Durable Power of Attorney for Health Care is a document that lets you name someone else to make decisions about your health care in case you are not able to make those decisions yourself. It gives that person (called your agent) instructions about the kinds of medical treatment you want.
A durable POA allows an agent to take action once the older person is “incapacitated.” In California, such POAs can be used to move a person with dementia to a different living arrangement.
You cannot give an attorney the power to: act in a way or make a decision that you cannot normally do yourself – for example, anything outside the law. consent to a deprivation of liberty being imposed on you, without a court order.
They are called “directives” because you are directing them about what you want done. In California, the part of an advance directive you can use to appoint an agent to make healthcare decisions is called a Power of Attorney for Health Care.Nov 17, 2018
Use (or do not use) a feeding tube. Even after you have signed the Medical Power of Attorney form, you have the right to make health care decisions for yourself as long as you are able to do so.
Examples of limitations you might choose include: 1 Provide comfortable, pain-free care 2 Do not keep me alive if I am going to remain in a coma 3 Use (or do not use) a feeding tube
The person you have designated as your agent. A person related to you by blood or marriage. A person entitled to any part of your estate after your death under a will or codicil executed by you or by the operation of law. Your attending physician. An employee of your attending physician.
Authority of Agent. Your agent makes decisions only when you are not able to make them. Unless you state otherwise, he/she has the same authority to make health care decisions as you have now. Your agent may consent, refuse to consent, or withdraw consent to medical treatment. He/she may make decisions about continuing or stopping life support ...
An employee of a health care facility in which you are a patient if the employee is providing direct patient care to you or is an officer, director, partner, or business office employee of the health care facility or of any parent organization of the health care facility.
Your health care provider. An employee of your health care provider, unless that employee is related to you. Your residential care provider (for example, nursing home or hospice) An employee of your residential care provider, unless that employee is related to you .
But making a health and welfare power of attorney means that someone who knows and loves you will be able to take charge of your care and speak up on your behalf if something like that happens. It also lets you leave instructions, so it’s clear how you’d like to be taken care of.
What about saying yes or no to life sustaining treatment? Life sustaining treatment is medical care that will keep you from dying. It might be a life-saving operation, or ‘life support’ machinery to breathe for you. But it could be as simple as antibiotics for a bad case of pneumonia.