A Health Care Power of Attorney can be executed to appoint an agent to make decisions for the principal, such as to admit the principal to a hospital, to hire or terminate doctors and nurses, and to arrange rehabilitation or long-term care. The Health Care Power of Attorney should contain a specific appointment of the agent as “health care representative” so that the agent will have access to private health care information; without this specific authorization, an agent may be told that the doctors, nurses, or hospital staff are unable to disclose private information. The Health Insurance Portability and Accountability Act (HIPAA) has restricted access to private health information. Older Powers of Attorney do not mention HIPAA and hospitals, doctors or nurses may refuse to discuss the patient’s diagnosis or treatment with the family. It is very important that older Powers of Attorney be updated and redone to incorporate changes such as HIPAA.
A Health Care Power of Attorney also addresses end-stage medical issues, and is a living will or advance directive. The principal should give guidance or binding instructions to the agent and doctor as to what treatments should or should not be administered. Execution of a Health Care Power of Attorney with end-of-life directives will allow doctors to terminate or not administer life support once the diagnosis has been made that the end is near. In an emergency, life saving measures will be used and life support would be commenced; only once the determination has been made that it is hopeless, then the Power can be used to allow termination. If no such authorizations exist, then the family may dispute the decision, perhaps even in court.
A written Healthcare Power of Attorney or Advance Directive Declaration provides the benefit of state law protections for medical providers, so that a doctor who discontinues life support at the express written directive of the patient cannot be held legally liable for wrongfully causing the death. Because of this protection, a doctor may be much more willing to comply with the patient’s wishes. For those people who feel very strongly that heroic measures or artificial life support are to be avoided, it is vitally important to have a signed Healthcare Power of Attorney with advance directive provisions.
If a doctor has diagnosed a terminal illness, the patient can obtain a “Do Not Resuscitate” Order or “DNR”. This must be signed by the doctor, and will direct all emergency and other medical personnel not to revive or resuscitate a terminal patient. DNR orders cannot be signed “just in case” and can only be issued if the patient is terminally ill.