Medical Power of Attorney

What is a Medical Power of Attorney?

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A Medical Power of Attorney (Medical POA) serves as a crucial legal document that enables a person, commonly referred to as the "principal," to appoint another person, known as the "agent" or "health care agent," to make health-related decisions on their behalf in the event they become incapacitated. This legal instrument is also known as a "Healthcare Power of Attorney" or "Durable Power of Attorney for Health Care."

Essentially, a Medical POA gives the agent the power to make medical decisions for the principal when they are unable to do so due to illness, injury, or mental incapacity. For instance, the agent can approve or deny specific treatments or surgeries as the principal's proxy. However, they must act in the best interest of the principal, respecting their beliefs, values, and previously expressed wishes.

Scenarios That Necessitate a Medical Power of Attorney

A Medical Power of Attorney becomes vital in situations where the principal becomes incapacitated and cannot make health-related decisions. Some scenarios include:

After a serious accident causing physical or mental incapacity
In cases of severe illness, like Alzheimer's or other forms of dementia
When the principal is in a coma or unconscious for a prolonged period

Preparing a Medical Power of Attorney form in advance ensures that the principal's healthcare decisions are in the hands of a trusted individual who understands their wishes, thereby eliminating potential disputes or confusion.

Who Benefits from a Medical Power of Attorney?

While anyone can benefit from having a Medical Power of Attorney, it is particularly beneficial for individuals with advancing age, severe health conditions, or those about to undergo high-risk surgery. However, even young and healthy individuals may also consider creating one, as it provides a safety net in case of unexpected health crises.

Legal Protections Granted by a Medical Power of Attorney

A Medical Power of Attorney provides essential legal protection for the principal by ensuring their health care wishes are respected, even if they can't express them themselves. It grants the agent the power to make health-related decisions, following the principal's instructions, values, and preferences. Also, it can prevent family disputes by clearly stating who is in charge of making these decisions.

Understanding Medical Power of Attorney Through Examples

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Example 1: An elderly parent may execute a Medical POA, designating one of their children as the health care agent to make medical decisions if they become unable to do so due to age-related cognitive decline.
Example 2: A person diagnosed with a terminal illness might use a Medical Power of Attorney to appoint a trusted friend or family member to make end-of-life decisions, ensuring their last wishes are honored.

A Medical POA strictly pertains to health-related decisions, while a Durable Power of Attorney covers a broader range of decisions, including financial and legal matters. However, when a Durable POA is specifically for health care, it works the same way as a Medical POA.

Yes, a principal can revoke a Medical Power of Attorney at any time, provided they are mentally competent. Revocation must typically be in writing, signed, and communicated to the agent and healthcare providers.

A Medical POA becomes effective when the principal becomes incapacitated and unable to make their own health-related decisions. This determination is usually made by the principal's primary physician.

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This Medical Power of Attorney (hereinafter referred to as the "Document") is made and executed on .

DESIGNATION OF HEALTH CARE AGENT

I, , residing at , hereby appoint:

Name:
Address:
Phone:
Email:

as my agent (attorney-in-fact) to make any and all health care decisions for me, except to the extent I state otherwise in this document. This Medical Power of Attorney takes effect if I become unable to make my own health care decisions and this fact is certified in writing by my physician.

ALTERNATE AGENTS

Add Alternate Agent?

AGENT'S AUTHORITY

My agent is authorized to make all health care decisions for me, including decisions to provide, withhold, or withdraw artificial nutrition and hydration and all other forms of health care to keep me alive, except as I state here:

WHEN AGENT'S AUTHORITY BECOMES EFFECTIVE

Authority effective immediately

Authority effective upon physician's determination

AGENT'S OBLIGATIONS

My agent shall make health care decisions for me in accordance with this power of attorney, any instructions I give in this document, and my other wishes to the extent known to my agent. To the extent my wishes are unknown, my agent shall make health care decisions for me in accordance with what my agent determines to be in my best interest. In determining my best interest, my agent shall consider my personal values to the extent known to my agent.

NOMINATION OF GUARDIAN

If a guardian of my person needs to be appointed for me by a court, I nominate my agent (or alternate) named above for appointment as guardian to serve without bond or security.

HIPAA RELEASE AUTHORITY

I intend for my agent to be treated as I would be with respect to my rights regarding the use and disclosure of my individually identifiable health information or other medical records. This release authority applies to any information governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C. 1320d and 45 CFR 160-164, and the regulations promulgated thereunder. I authorize any physician, healthcare professional, dentist, health plan, hospital, clinic, laboratory, pharmacy, or other covered healthcare provider, any insurance company, and the Medical Information Bureau, Inc., or other healthcare clearinghouse that has provided treatment or services to me, or that has paid for or is seeking payment from me for such services, to give, disclose, and release to my agent, without restriction, all of my individually identifiable health information and medical records regarding any past, present, or future medical or mental health condition.

SPECIFIC MEDICAL DIRECTIVES

Include Life-Sustaining Treatment Preferences?

Include Artificial Nutrition and Hydration Preferences?

Include Pain Relief Preferences?

Include Other Medical Wishes?

ORGAN DONATION

Status:

I wish to be an organ donor.

I do not wish to be an organ donor.

I direct that my agent decide about organ donation.

Governing Law

This Medical Power of Attorney is governed by the state laws of .

EFFECT OF COPY

A copy of this Medical Power of Attorney has the same effect as the original.

SIGNATURE

I sign my name to this Medical Power of Attorney on .

Principal Signature: ______________________________
Print Name: _______________

Include Witness Signatures?

Include Notary Acknowledgment?

ACCEPTANCE BY AGENT

I accept this appointment and agree to serve as agent for health care decisions. I understand I have a duty to act consistently with the principal's desires as stated in this document or otherwise made known to me. I understand that this document gives me authority to make health care decisions for the principal only if the principal becomes incapacitated. I understand that I must act in good faith in exercising my authority under this power of attorney. I understand that the principal may revoke this power of attorney at any time in any manner.

If I choose to withdraw as agent, I must inform the principal of my decision. If the principal is not capable of understanding my withdrawal, I must inform the principal's caregivers of my withdrawal.