This type of document allows you name another individual as an agent to make health care decisions for you if you become incapable of making your own decisions or if you want someone else to make those decisions for you now even though you are still capable. We recommend that you also name an alternate agent to act for you if your first choice is not willing, able, or reasonably available to make decisions for you.
Unless the form you sign limits the authority of your agent, your agent will have the authority to make all health care decisions for you. This authority will include the ability to:
- Consent or refuse consent to any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect a physical or mental condition.
- Select or discharge health care providers and institutions.
- Approve or disapprove diagnostic tests, surgical procedures,and programs of medication.
- Direct the provision, withholding, or withdrawal of artificial nutrition and hydration and all other forms of health care,including cardiopulmonary resuscitation.
- Make anatomical gifts, authorize an autopsy, and direct disposition of remains.
Regardless of whether or not you decide to appoint an agent, this form allows you to give specific instructions about any aspect of your health care. Choices are provided for you to express your wishes regarding whether you do or do not want to be kept on life support and the administration of pain relief medications. Space is also provided for you to add to the choices you have made or for you to write out any additional wishes. You also have the option to leave these decisions up to the discretion of your named agent.
Included in this document is the ability for you to express an intention to donate your bodily organs and tissues following your death and to designate a physician to have primary responsibility for your health care.
We suggest that after completing this form, you give a copy of the signed and completed form to your physician, to any other health care providers you may have, to any health care institution at which you are receiving care, and to any health care agents you have named.
Choosing the right person for this incredibly important job can be a challenge. Our office is experienced in helping clients evaluate the potential candidates and make the choice that is most appropriate. You should talk to the person you have named as agent to make sure that he or she understands your wishes and is willing to take the responsibility. You have the right to revoke this advance health care directive or replace this form at any time.
Please contact our office if you would like to put this type of document in place.