Health Care Proxy

Unless the power of attorney for health care provides otherwise, the agent's authority becomes effective only on a determination that the principal lacks capacity and ceases on a determination that the principal has…

Definition: a power of attorney for health care is a written document designating an agent to make health care decisions for the principal.

The supervising health care provider, an employee of the health care institution where the patient is receiving care, and an operator or employee of a community care or residential care facility where the patient is…

An adult having capacity may execute a power of attorney for health care under Article 2, which may authorize the agent to make health care decisions and may also include individual health care instructions, and the…

Text of the Health Care Decisions Law: unless the advance health care directive specifies otherwise, a person then authorized to make health care decisions for a patient has the same rights as the patient to request,…

An agent must decide in accordance with the principal's individual health care instructions, if any, and other wishes to the extent known to the agent;

What an ADVANCE HEALTH CARE DIRECTIVE is in California: either an individual health care instruction or a power of attorney for health care, or both in one document. California combines the two instruments;

Unless a written advance health care directive specifies otherwise, a determination that a patient lacks or has recovered capacity, or that another condition exists that affects an individual health care instruction or…

California: a written directive is dated and signed by the patient, or in the patient's name by another adult in the patient's presence and at the patient's direction.

The witness restrictions: not the patient's health care provider or their employee, not the operator or employee of a community care or residential care facility, not the appointed agent, and at least one witness who is…

Connecticut rule that no physician, health care provider or health care insurer shall require a person to execute a living will or appoint a health care representative as a condition of treatment or of receiving health…

How a living will or appointment is proved and the physician's role in determining incapacity. Background to when the document actually operates.

THE FORM TO USE. One document carrying health care instructions, the appointment of a health care representative, the designation of a conservator for future incapacity, and an anatomical gift.

Connecticut: a person eighteen or older appoints a representative using a document under section 19a-575a or 19a-577, signed and dated in the presence of two adult witnesses who also sign.

The standalone statutory form for appointing a health care representative, for a client who wants only the appointment and not the full combined document.

It becomes operative only when the document is FURNISHED to the attending physician or APRN AND the declarant is determined by them to be incapacitated. A signed directive in a drawer does nothing.

Connecticut rule that a person eighteen or older may execute a document designating another adult to make certain decisions and have certain rights and obligations on the maker's behalf under the statutes the section…

Connecticut rule that a licensed institution must furnish a copy of a patient's health record, including bills, laboratory reports, prescriptions and other technical information, on the written request of the patient,…

The statutory form for health care instructions, the living will half of a Connecticut directive. Section 19a-575a's combined form is usually the better starting point because it also appoints a representative.

A living will may be revoked at any time, in the manner the section provides, and the section protects those acting without knowledge of a revocation. Capacity is not the barrier to revoking that clients expect.

Delaware: section 2508 requires the health care power to be in a record signed by the individual and an adult witness.

Delaware rule that an individual may create an advance directive addressing only mental health care, containing a health-care instruction (preferences on professionals, facilities, admission, medications, refusals and…

Delaware rule that an agent or default surrogate owes the individual a fiduciary duty and must decide in accordance with the individual's advance directive and other known or reasonably ascertainable goals, preferences…

What the agent or surrogate may decide, subject to any limits in the directive. Read with section 2519's limitations before promising a client what their agent can do.

The provider's duties on receiving a directive, including recording it and complying or transferring. Encourage the client to give a copy to their physician while well.

Delaware rule that a guardian may refuse to comply with or revoke the individual's advance health-care directive only if the appointing court expressly permits it by order, and that, unless a court orders otherwise, a…

Delaware rule that protected health information held under the subchapter is not public information and may not be disclosed without the informed consent of the individual or the individual's lawful representative…

The Act's defined terms, including advance health-care directive, agent, health-care instruction and surrogate. Delaware combines the instruction and the appointment into one ADVANCE HEALTH-CARE DIRECTIVE;

Delaware rule that a finding of lack of capacity must be communicated to the individual and the individual's surrogate, that the individual may object orally, in a record or by another clear act, and that an objection…

Delaware rule that the individual found to lack capacity, a responsible health-care professional, the institution, or a person interested in the individual's welfare may petition the Court of Chancery in the county…

District of Columbia: section 21-2205 requires a dated health care power signed by the principal and two adult witnesses who affirm sound mind and freedom from duress.

Provides an optional statutory form for the health-care power of attorney, requiring the principal's signature, two witnesses who personally know the principal and attest to capacity and absence of duress, and at least…

District of Columbia text: no health-care provider may require an individual to execute a durable power of attorney for health care as a condition of services or facility admission;

Allows the donor, the donor's health-care agent unless restricted, a parent of an unemancipated minor, or the donor's legal guardian to make an anatomical gift during the donor's lifetime.

A gift may be made via driver's license or ID designation, a will (effective at death regardless of probate status), donor-card or registry enrollment, or, for a terminally ill donor, oral communication to two adults…

District of Columbia text: incapacity to make a health-care decision must be certified by two District-licensed professionals, one a physician and one a qualified psychologist or psychiatrist, at least one of whom…

Defines terms for the Health-Care Decisions chapter, including attorney in fact as the person receiving health-care decision authority, incapacitated individual, and durable power of attorney for health care as…

Gives the health-care attorney in fact authority to consent to, refuse, or withdraw treatment, access records, and make provider and facility decisions, requiring the agent to follow the principal's expressed wishes or,…

A principal may revoke the attorney in fact's appointment by oral or written notice, and the health-care POA is automatically revoked by dissolution, annulment, or termination of the principal's marriage or domestic…

Defines the Natural Death Act terms: a declaration is a witnessed document executed under § 7-622, a life-sustaining procedure excludes comfort care or pain management, and a qualified patient has executed a declaration…

Florida text allowing the patient's family, the facility, the primary physician, or another directly affected interested person to seek expedited judicial intervention under Florida Probate Rule 5.900 if the surrogate…

Florida: a surrogate designation under section 765.202 is signed in the presence of two subscribing adult witnesses; a principal unable to sign may direct another to sign in the witnesses' presence.

A parent may designate a health care surrogate for a MINOR CHILD, which is a distinct Florida instrument. Raise it with any client who has children and travels or leaves them with caregivers.

A Florida LIVING WILL must be signed by the principal in the presence of TWO SUBSCRIBING WITNESSES, AND ONE OF THEM MAY BE NEITHER A SPOUSE NOR A BLOOD RELATIVE.

Supervised electronic witnessing, including identity and location, questions and notices, vulnerable-adult restrictions and statutory exceptions.

The advance directive chapter's defined terms, including health care surrogate, end-stage condition, persistent vegetative state and terminal condition. Those three conditions are the triggers for a living will;

How an advance directive is amended or revoked, including by a later directive or by physical act. Capacity is not the barrier clients expect.

Florida text requiring health care facilities to give patients written information on advance directive rights and document whether an advance directive exists, barring providers and facilities from requiring a patient…

Florida text providing that an advance directive executed in another state in compliance with that state's law or Florida law is validly executed for purposes of chapter 765.

The suggested statutory form for designating a health care surrogate. A good starting point; it is suggested rather than mandatory.

Maryland text: a health care provider that intends not to comply with an instruction of a health care agent or surrogate must tell the person that it declines, that a transfer may be requested and that it will make…

Maryland definitions for the Confidentiality of Medical Records Act, including common ownership, directory information, health care provider, medical record, person in interest and the other terms §§ 4-302 to 4-309 use.

Where a patient certified incapable has appointed no agent, or the agent is unavailable as the section defines that term, decisions pass down a ranked list beginning with a court-appointed guardian, then the spouse or…

The Department, with the Maryland Institute for Emergency Medical Services Systems and the State Board of Physicians, maintains the MOLST form, and the listed facilities (assisted living, home health, hospice, hospital,…

Defines advance directive to include a witnessed written or electronic document, a witnessed oral statement and, in limited circumstances, an unwitnessed electronic video record, along with health care agent, surrogate,…

An advance directive may be revoked at any time by a signed and dated written or electronic document, by physical cancellation or destruction, by an oral statement to a health care practitioner, or by executing a later…

Before treatment authorized under this subtitle is provided, withheld or withdrawn, the attending physician and a second physician or nurse practitioner must certify in writing, on personal examination, that the patient…

Maryland text: an advance directive, emergency medical services do not resuscitate order or order regarding life-sustaining treatment executed in another state is deemed validly executed if it complies with Maryland law…

A gift may be amended or revoked by a later signed record, destruction of the document with intent, an oral statement during terminal illness, ordinary will amendment for a will-based gift, or written notice to the…

Maryland text on the authorization a release must satisfy: it must be in writing, dated and signed by the person in interest, name the provider, identify the recipient, and state a validity period not exceeding one year…

Massachusetts: a competent adult's written health care proxy is signed by the adult or at the adult's direction in the presence of two other adults who subscribe as witnesses under chapter 201D, section 2.

Massachusetts provider-records rule: a health care provider who keeps records for a patient must permit inspection by the patient or an authorized representative and furnish a copy on request for a reasonable fee as…

Massachusetts rule that a person may not require or prohibit the execution of a health care proxy as a condition for providing health care services or insurance to an individual. Signing a proxy is voluntary.

Who may serve as health care agent, with the section's limits on operators, administrators and employees of facilities where the principal is a patient or resident, unless related to the principal.

What the proxy must contain: identification of the principal and agent, a statement that the principal intends the agent to have authority to make health care decisions, and the section's other required elements,…

The agent may make any health care decision the principal could make, subject to any limits stated in the proxy and to the section's rules on life-sustaining treatment.

How a proxy is revoked, including by a later proxy, by notification, or by DIVORCE or legal separation where the spouse was the agent, unless the principal specified otherwise.

Massachusetts hospital-records statute: licensed or state-supported hospitals and clinics must keep treatment records, may keep them in the media the section allows, may destroy them only after the retention period and…

The health care proxy chapter's defined terms, including health care agent, health care decision and attending physician. Massachusetts says HEALTH CARE PROXY and HEALTH CARE AGENT; use its vocabulary.

What happens where a physician declines to honour the proxy, including the duty to transfer. Encourage the client to discuss the proxy with their physician while well.

An advance directive becomes operative only when it has been transmitted to the attending physician or the health care institution and it has been determined under 26:2H-60 that the patient lacks capacity to make the…

A psychiatric advance directive must be signed and dated by the declarant and witnessed by an adult attesting that the declarant is of sound mind and free of duress, and the designated mental health representative and…

A declarant may designate as health care representative any adult with mental capacity, including a spouse, civil union or domestic partner, adult child, parent, other family member, friend or religious advisor, and may…

The attending physician determines whether the patient lacks capacity for a particular health care decision, must state that determination in writing with an opinion on the nature, cause, extent and probable duration of…

Consistent with the advance directive, life-sustaining treatment may be withheld or withdrawn when it is experimental and not a proven therapy, is likely to be ineffective or futile, or is likely merely to prolong an…

New Jersey: date and sign the advance directive by or at the direction of the declarant.

Once it is determined that the patient lacks decision making capacity, the health care representative has authority to make health care decisions, acting in good faith and within the bounds of the directive and the act,…

The attending physician, the health care representative and any additional physician responsible for the patient's care must discuss the nature and consequences of the patient's condition and the risks, benefits and…

Defines the POLST form as a standardized document for a patient with advanced chronic illness or a life expectancy under five years, and defines the professionals who may sign it.

Professionals and institutions must treat the patient consistently with a completed POLST signed by the patient or representative and by the attending physician, advanced practice nurse or physician assistant, and an…

New York: the principal dates and signs the proxy in the presence of two adult witnesses, who also sign and state that execution appeared willing and free of duress.

MOLST is a physician order set, valid in all settings including by emergency medical services, that translates a seriously ill patient's wishes into actionable orders about resuscitation, intubation, hospitalisation and…

The agent's authority begins when the attending practitioner determines to a reasonable degree of medical certainty that the principal lacks capacity, records the determination and its cause, extent and probable…

No person may require or prohibit the execution of a health care proxy as a condition for providing health care services or insurance to the individual.

Article 29-CC applies to health care decisions in a hospital, and to hospice decisions wherever made, for a patient who lacks decision-making capacity, and to do-not-resuscitate decisions in mental hygiene hospitals;

The Department's optional health care proxy form, with the agent and alternate designation, the artificial nutrition and hydration statement that PHL 2982 makes necessary, the duration and organ-donation options, and…

Defines health care agent, health care decision, health care proxy, attending practitioner, reasonably foreseeable and the other terms article 29-C uses, including the reach of health care decision over the withholding…

The agent may make any health care decision the principal could make, after consultation with a physician or other listed practitioner, in accordance with the principal's wishes including religious and moral beliefs, or…

A health care provider given a health care proxy must have it or a copy placed in the principal's medical record, and must comply with an agent's good-faith decisions as if the principal had made them, subject to the…

A competent adult may revoke a proxy by notifying the agent or a health care provider orally or in writing or by any act evidencing an intent to revoke, by executing a later proxy, and a proxy naming a spouse is revoked…

What the health care attorney in fact may decide, including the specific conditions the section imposes before life-sustaining treatment may be withheld or withdrawn, and the express statement required for nutrition and…

The defined terms for Ohio's health care power of attorney. Ohio keeps the health care power in chapter 1337 alongside the financial one but executes it differently; do not assume one set of formalities covers both.

Ohio's printed statutory form for the health care power of attorney, with the notice to the principal the statute requires. Start from it.

Ohio text allowing a mental health declaration to designate an adult proxy and alternate who may decide only when the declaration is operative and consistently with the declarant's expressed desires, barring the…

Ohio text allowing an adult with capacity to execute a separate declaration governing mental health treatment, signed at the end, dated, and witnessed or acknowledged under section 2135.06, which may designate a proxy…

What the attending physician and a second physician must determine before a declaration operates, and the physician's duties once it does. The declaration does nothing until those determinations are made and recorded.

The authority and immunity of nurses and physician assistants acting under Ohio's DNR regime. Background that explains why a DNR is a clinician's instrument rather than one the client executes alone.

Ohio: the health care power under section 1337.12 is signed at the end and dated. The principal signs or acknowledges the signature in each qualifying witness's presence, then the witnesses subscribe after the…

How an Ohio health care power is revoked, including the effect of divorce, dissolution or annulment on a spouse attorney in fact. A divorcing client who still wants their spouse to decide must say so expressly.

Ohio text barring providers, insurers, and plans from requiring anyone to create or revoke a durable power of attorney for health care as a condition of admission, care, insurance, or benefits;

Unless the document says otherwise, it becomes operative when a copy reaches the attending physician AND the physician determines the principal is incompetent, and it becomes inoperative when the principal regains…

The physician must certify an end-stage medical condition or permanent unconsciousness in writing and record health care decisions in the medical record. The certification is what makes the client's document operate.

Text of the statutory example of a combined document, Durable Health Care Power of Attorney and Health Care Treatment Instructions (Living Will): Part I gives introductory remarks on health care decision making and a…

The agent may make any health care decision the principal could make, including admission to a facility, and the authority can extend past death to anatomical gifts, disposition of remains and consenting to autopsy.

A living will only becomes operative when a copy reaches the attending physician AND the physician determines the principal is incompetent and either has an end-stage medical condition or is permanently unconscious.

A principal may appoint more than one health care agent, who act jointly unless the document expressly provides otherwise, and one or more successor agents, who serve in the order named unless the principal expressly…

Where there is no health care power of attorney or no available agent, a health care representative from the statutory class may decide, in the order and on the conditions given.

The defined terms that drive the whole chapter, including advance health care directive, attending physician, end-stage medical condition, life-sustaining treatment and permanently unconscious.

The Texas MEDICAL POWER OF ATTORNEY, a separate instrument from the financial durable power, and the agent's scope. Do not try to cover health care in the Estates Code power; the statutes are separate on purpose.

Texas definitions for the medical power of attorney subchapter, including adult (18 or older or with disabilities of minority removed), agent (an adult to whom health care decision authority is delegated), health care…

The principal signs in the presence of two qualifying witnesses, who also sign, or acknowledges the signature before a notary. At least one witness must satisfy section 166.003(2).

The medical power of attorney must substantially follow this statutory form, which includes its disclosure statement, agent designations, limitations and alternative execution blocks.

Texas text allowing a near relative or a responsible adult directly interested in the principal, including a guardian, social worker, physician, or clergyman, to sue to revoke a medical power of attorney because the…

Texas text barring a person from exercising an agent's authority while serving as the principal's health care provider or residential care provider, or as an employee of either unless the person is the principal's…

Texas text requiring a probate court, on motion in a guardianship proceeding or on the guardian's petition, to decide whether to suspend or revoke the agent's authority, considering the principal's preferences stated in…

Texas definitions for chapter 166, including advance directive (a directive, an out-of-hospital DNR order, or a medical power of attorney), artificially administered nutrition and hydration, attending physician,…

Texas text allowing a declarant, witness, or notary to sign an advance directive or a written revocation with a digital signature meeting listed security requirements or an electronic signature that is capable of…

Texas text providing that a medical power of attorney is revoked by oral or written notice from the principal to the agent or a licensed health or residential care provider, or any other act showing specific intent to…

A lifetime anatomical gift may be made by the donor, including a minor at least fifteen years and six months old, by the donor's health care agent unless the directive prohibits it, by a parent of an unemancipated…

An agent appointed in an advance directive has authority to make the health care decisions the directive specifies once the declarant is determined incapable of making an informed decision, and takes decision-making…

A physician may refuse care he determines medically or ethically inappropriate, but only BASED SOLELY ON THE PATIENT'S MEDICAL CONDITION.

Virginia health records privacy statute: it recognizes an individual's right of privacy in health records, requires disclosure to the individual on request, bars redisclosure beyond the purpose of the original…

Virginia text: an advance directive may authorize an agent to approve the declarant's participation in a health care study approved by an institutional review board or a research review committee under Chapter 5.1 of…

Virginia text: on petition of any person to the circuit court where the patient resides or is located, the court may enjoin providing, continuing, withholding or withdrawing health care under the Health Care Decisions…

Virginia text: a person may file a health care power of attorney, an advance directive under the Health Care Decisions Act, an anatomical gift declaration or other advance-planning documents such as a Durable Do Not…

An advance directive is either a witnessed written document voluntarily executed under § 54.1-2983 or a witnessed oral statement made under that section after the declarant is diagnosed with a terminal condition, made…

A declarant capable of understanding the nature and consequences of his actions may revoke an advance directive at any time by a signed and dated writing, by physical cancellation or destruction by himself or by another…

An incapacitated patient's contemporaneous protest generally overrides the agent and the directive, except in narrow documented circumstances, and a protest alone does not revoke the document.