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Durable Power of Attorney laws - Information on the law about Durable Power of Attorney

care health physician principal

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
ALABAMA §26-1-2 Agent may authorize withholding or withdrawal of life-sustaining treatment, and make all other health care decisions. Must designate person as attorney and state, "This power of attorney shall not be affected by disability, incompetency, or incapacity of the principal." Revocable by written revocation, destruction of document, or verbal expression of intent to cancel. Directives prepared in other states are valid if in compliance with Alabama law.   Health care providers who rely in good faith on agent's directions are immune from civil and criminal liability.
ALASKA 13.26.332, 335, et seq. Consent or refusal to consent to medical care or relief for the principal from pain but agent may not authorize the termination of life-sustaining procedures; may include provision indicating whether a living will has been executed (1) Must be set out in substantially the same form as found in statute §13.26.332; (2) designate health care decisions to agent Revocable at any time   A third party shall honor the terms of a properly executed power of attorney, but physician may withdraw after services of another physician have been obtained A third party who relies on reasonable representations of an attorney-in-fact does not incur a liability to the principal or principal's heirs, assigns, or estate
ARIZONA 36-3221, et seq. Health Care Power of Attorney Power to give or refuse consent to all medical, surgical, hospital, and make health care decisions on that persons behalf (1) Adult; (2) in writing; (3) language clearly indicating intent to create a health care power of attorney; (4) dated; (5) signed; (6) witnessed by at least one adult or a notary public and who is not related to principal by blood, marriage, or adoption & not entitled to any of principal's estate Person may revoke health care directive or disqualify a surrogate by (1) written revocation; (2) orally notifying surrogate or health care provider; (3) making new health care directive; (4) any other act demonstrating specific intent to revoke Health care directive prepared in another state is valid in this state if it was valid where and at the time it was adopted to the extent it does not conflict with the criminal laws of Arizona   Health care provider making good faith decisions in reliance on apparently genuine health care directive or decision of a surrogate is immune from civil, criminal, and professional discipline for that reliance

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
ARKANSAS 20-17-201, et seq. Arkansas Rights of the Terminally Ill & Permanently Unconscious Act Any medical procedure or intervention that will serve only to prolong the dying process or to maintain the patient in a condition of permanent unconsciousness The declaration may appoint a health care proxy who is at least 18 yrs. old as attorney-infact to make health care decisions including withholding or withdrawing of life-sustaining treatment Revocable at any time in any manner by the declarant without regard to declarant's mental/physical condition. Effective upon communication to attending physician A declaration executed in another state in compliance with the laws of that state or Arkansas law is validly executed Physician shall as promptly as practicable take all reasonable steps to transfer care to another physician Physician whose actions under this chapter are in accord with reasonable medical standards is not subject to criminal, civil, or professional liability with respect to them
CALIFORNIA Probate §4650, §4700 et seq. Durable Powers of Attorney for Health Care Decisions on any care, treatment, service, or procedure to maintain, diagnose, or treat an individual's physical or mental condition; including decision to begin, continue, increase, limit, discontinue or not begin any health care. Same right as principal to receive information and consent regarding health care decisions and records except to consent to commitment, convulsive treatment, or psychosurgery, sterilization or abortion. Durable power of attorney must specifically authorize the attorney-in-fact to make health care decisions; dated; witnessed by 2 attesting to the principal's signature and signing statutory declaration (§4701) or by a notary public; prevails over declaration (§7185 et seq.); substantially same form as §4703 (statutory form) No authority while principal can give informed consent to a health care decision. Anytime while principal has capacity to give a durable power of attorney, he may (1) revoke the appointment of the attorney-in-fact orally or in writing; (2) revoke the agent's authority by notifying the physician orally or in writing; (3) a subsequent durable power of attorney revokes prior one; (4) divorce revokes any designation of former spouse Enforceable if executed in another state or jurisdiction in compliance with the laws of that state or jurisdiction or in substantial compliance with the laws of California   Subject to limitations, a physician acting in good faith on decision of attorney-in-fact is not subject to criminal, civil, or professional liability except to the same extent that would be the case if the principal, having had capacity to give informed consent, had made the health care decision on his/her own behalf under like circumstances
COLORADO 15-14-503, et seq. Colorado Patient Autonomy Act Authority of an agent to act on behalf of principal who lacks decisional capacity in consenting to or refusing medical treatment including artificial nourishment and hydration; may include conditions or limitations of agent's authority Directive must contain the words, "This power of attorney shall not be affected by disability of the principal." Divorce, dissolution, annulment, or legal separation revokes any designation of former spouse as agent; otherwise can be revoked at any time A durable power of attorney executed in another state shall be presumed to comply with this law and may, in good faith, be relied on by a health care provider Physician must provide for prompt transfer; physician must not provide care and comfort pending transfer No criminal or civil liability or regulatory sanction for complying in good faith with medical treatment decision of agent acting in accordance with advanced medical directive

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
CONNECTICUT 1-54a; 19a-570, et seq. Consent, refuse consent, or withdraw consent to any medical treatment other than that designed solely to maintain physical comfort, the withdrawal of life support systems, or of nutrition or hydration; does not apply to pregnant patient See statutory form §1-43 for power of attorney or appointment of attorney-in-fact for health care decisions see form in §19a-575a—must be 18 yrs., signed, dated in presence of two adult witnesses May be revoked at any time, in any manner; automatically revoked by divorce, legal separation, annulment, or dissolution of marriage if spouse is appointed as health care agent, unless principal specifies otherwise   Physician shall act as promptly as practicable and take all reasonable steps to transfer patient to complying physician Physician withholding, removing life-support system of an incapacitated patient shall not be civilly or criminally liable if decision was based on physician's (1) best medical judgment; (2) physician deems patient in a terminal condition; (3) patient's wishes were considered according to an executed document
DELAWARE 16 §2501, et seq. Grant, refuse, withdraw consent to provision of medical treatment, including right to refuse medical treatment which would extend appointer's life (1) Adult; (2) written declaration; (3) attending physician judges appointer incapable due to condition resulting from illness or injury of making decision to accept or refuse medical treatment; (4) signed by appointer or another person at his express direction and in his presence; (5) dated; (6) 2 or more adult witnesses Revocable at any time without regard to declarant's mental state or competency by (1) destruction of declaration with intent to revoke; (2) oral statement in presence of 2 persons 18 yrs. or older expressing intent to revoke; (3) written revocation signed and dated by declarant or (4) new declaration with contrary intent Directives of other states in compliance with the laws of that state or of Delaware are valid. Must provide continuing care and not impede the transfer of the patient to another health care provider. Physicians or nurses acting in reliance on properly executed document are presumed to be acting in good faith and there is no civil or criminal liability unless negligent

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
DISTRICT OF COLUMBIA 21-2201 Health Care Decisions To grant, refuse, withdraw consent to the provision of any health-care service, treatment, or procedure if principal is incapable of making or communicating decisions himself (1) Competent adult; (2) in writing; (3) must include language clearly communicating the intent for attorney-in-fact to have authority to make health-care decisions on behalf of the principal with language that power is effectuated upon principal's incapacity; (4) dated; (5) signed; (6) in presence of 2 adult witnesses; sample form §21-2207 Revocable at any time by notifying health care provider or attorney-in-fact orally or in writing. Divorce automatically revokes designation of former spouse      

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
FLORIDA 765.201, et seq. Health Care Surrogate Act All health care decisions regarding principal's health care during principal's incapacity, including life-prolonging procedures: any medical procedure, treatment, or intervention which utilizes mechanical or other artificial means to sustain, restore, supplant a spontaneous vital function and serves only to prolong the dying process of a patient in terminal condition. Does not include medication or medical procedure to provide comfort care or to alleviate pain; cannot withhold or withdraw life prolonging procedures from pregnant patient prior to viability (1) Competent adult (2)signed; (3) in presence of 2 adult witnesses Revocable at any time by principal by (1) signed, dated writing; (2) destruction of declaration; (3) oral expression of intent to revoke; (4) subsequent advance health care directive materially different from the previously executed advance directive; (5) divorce revokes any designation of the former spouse as surrogate An advance directive executed in another state in compliance with the laws of that state or Florida is validly executed Physician should make reasonable efforts to transfer to a willing health care provider. Physician unwilling to carry out the patient's wishes because of moral or ethical beliefs must within 7 days: (1) transfer the patient and pay the cost of transporting the patient to another health care provider or (2) carry out the wishes of the patient unless provisions of judicial intervention Health care facility, provider, or other person acting under their direction is not subject to criminal, civil, or professional liability for carrying out health care decision
GEORGIA 31-36-1, et seq. Durable Power of Attorney for Health Care All powers the individual may have to be informed about and to consent or refuse to consent to any type of health care for the individual including withholding or withdrawal of life-sustaining or death-delaying procedures or after death, anatomical gifts, autopsies or disposition of remains (1) In writing; (2) signed by principal; (3) attested and subscribed by 2 or more competent adult witnesses; (4) statutory form §31-36-10 may be used Revocable at any time by principal without regard to physical or mental condition by (1) destruction of the document; (2) written revocation signed and dated by the principal; (3) by oral or any other expression of intent to revoke in presence of an adult witness who within 30 days must sign and date in writing confirming the expression of such intent; (4) divorce revokes agency in former spouse   Physician should promptly inform the agent who is responsible to make the transfer, but physician will continue to afford consultation and care in connection with the pending transfer No health care provider subject to any civil, criminal, or professional liability solely for complying with decision of agent

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
HAWAII 551D-1, et seq. Uniform Durable Power of Attorney Act Agent authorized to make any lawful health care decisions that could have been made by principal at time of election. Agent may decide that principal's life should not be prolonged through surgery, resuscitation, life-sustaining medicine, or procedures for provision of nutrition or hydration if explicitly appointed (1) Competent adult; (2) in writing and signed by principal or another in his or her presence at expressed direction; (3) dated; (4) in presence of 2 or more adult witnesses; (5) signature notarized; (6) with words such as "This power of attorney shall not be affected by the disability (or become effective upon disability) of principal." (Sample form §551D-2.6) Effective only during period of incapacity of principal as determined by licensed physician. Not revoked until notice of actual death or disability of principal is given to attorney-in-fact (durable or otherwise).      
IDAHO 39-4505, et seq. Natural Death Act Health care decisions for principal, meaning consent, refusal of consent, or withdrawal of consent to any care, treatment, services, or procedure to maintain, diagnose, or treat an individual's physical condition. Also includes life-prolonging care decisions (see Living Wills for description of life-prolonging measures) (1) Signed by principal; (2) dated; (3) signed by 2 witnesses; 4) person must be adult; (5) may list alternative holders of power (sample form §39-4505) Effective only when competent person is unable to communicate rationally. Revocable at any time by the maker without regard to competence by (1) destruction of the document; (2) by written, signed revocation; (3) by verbal expression of intent to revoke.   Physician may withdraw without civil or criminal liability provided physician makes a good faith effort to assist patient in transferring before his/her withdrawal No civil or criminal liability for physician acting in accordance with wishes of patient as expressed by statutory procedure

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
ILLINOIS 755 ILCS 45/4-1 Powers of Attorney for Health Care Law Health care powers may be delegated to an agent and include consent or refusal or withdrawal of any type of health care for individual. May extend beyond principal's death if necessary to permit anatomical gift, autopsy, or disposition of remains Neither attending physician nor health care provider may act as agent (statutory short form at 45/4-10). Living will not operative as long as properly authorized agent is available. Revocable at any time by principal without regard to mental or physical condition by (1) written revocation signed and dated; (2) oral expression in presence of witness who signs and dates a written confirmation; (3) destruction of power of attorney in manner indicating intent to revoke   Agent responsible for transfer after being promptly informed by attending physician of his refusal or failure to comply, but attending physician must afford all reasonably necessary consultation and care in connection with transfer No civil, criminal, or professional liability if good faith reliance on any decision or direction by agent not clearly contrary to terms of a health care agency
INDIANA 16-36-1-1, et seq. Health Care Consent Appoint a representative to act in matters affecting the appointer's health care: any care, treatment, service, or procedure to maintain, diagnose, or treat an individual's physical or mental condition including admission to a health care facility and disclosure of medical records to health care provide; this appointment does not affect individual's authorization re: life-prolonging measures (i.e. a living will) (1) In writing; (2) signed by appointer; (3) witnessed by adult; (4) may specify conditions and terms of the authority delegated; (5) begins when appointer becomes incapable of consenting Individual capable of consenting to health care may revoke appointment at any time by notifying representative or health care provider orally or in writing. Individual who may consent to his own health care may disqualify others from consenting or revoking appointment for the individual (disqualification must be in writing)     No criminal, civil, or professional liability for a physician acting in good faith in reliance on the agent's direction

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
IOWA 144B.1, et seq. Durable Power of Attorney for Health Care Consent, refusal of consent, or withdrawal of consent to health care. Attorney-in-fact has priority over court-appointed guardian to make health care decisions; does not include provision of nutrition or hydration except when required parenterally through intubation (1) Explicitly authorizes attorney-in-fact to make health care decisions; (2) 2 adult witnesses signing in the presence of each other and the principal; (3) notarized; (4) substantially complies with requirements (sample form 1448.5) May be revoked at any time in any manner by which principal is able to communicate intent to revoke. Power revoked in case of divorce where spouse designated durable power of attorney for health care. Similar document executed in another state in compliance with the laws of that state is valid and enforceable in Iowa; to the extent the document is consistent with Iowa law. Unwilling physician must make provisions to transfer patient to willing health care provider Health care provider not subject to civil or criminal liability or professional disciplinary action if acting in good faith on decision of attorney-in-fact
KANSAS 58-625 et seq. Durable Power of Attorney for Health Care Decisions Consent, refuse consent, or withdraw consent to any care, treatment, service, or procedure to maintain, diagnose, or treat a physical or mental condition and make decisions about organ donation, autopsy, and disposition of body; make all necessary arrangements for principal at any hospital/facility and employ health care personnel; request and review and execute any information regarding principal's affairs, including medical and hospital records. (1) Writing must have words of intent that principal conferred authority to be exercised notwithstanding principal's subsequent incapacity; (2) dated; (3) signed; (4) in presence of 2 adult witnesses or notarized; (5) substantially in statutory form of §58-632 (6) effective upon occurrence of principal's disability or incapacity By an instrument in writing witnessed as required for power of attorney or "set out another manner of revocation, if desired." Any durable power of attorney for health care decisions which is valid under the laws of the state of the principal's residence at the time it was signed is valid under the act.    

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
KENTUCKY 311.621 et seq. Kentucky Living Will Directive Act. Surrogate may make health care decisions grantor could make if he or she had decisional capacity, provided all decisions are in accordance with granter's wishes and surrogate has considered recommendations of attending physician; these decisions include withholding or withdrawal of artificial nutrition or hydration if (1) death is imminent (i.e. death is expected within a few days); (2) provision of nutrition cannot be physically assimilated; (3) burden or provision of such nutrition and hydration outweighs benefit. (Artificial nutrition or hydration not to be withdrawn if needed for comfort or relief of pain.); (4) When patient is in permanently unconscious state and advanced directive has authorized withdrawal or withholding of such nutrition and hydration. (1) Grantor with decisional capability; (2) may designate 1 or 2 adults as surrogates; (3) if 2 or more, any decisions must be unanimous; (4) in writing, dated and signed by grantor; (5) 2 adult witnesses, signed in presence of grantor and in presence of each other or notarized; (6) surrogate may not make decisions when physician has determined in good faith that grantor has decisional capability (1) May be revoked in whole or in part or surrogate's powers reduced or limited at any time if grantor has decisional capacity; (2) oral statement of intent to revoke in presence of 2 adults, one of whom is a health care provider; (3) destruction of declaration with intent to revoke; (4) effective immediately for attending physician once revocation received; (5) oral statement by grantor with decisional capacity to revoke overrides previous written directive Directives made outside the provisions of this act does not restrict health care providers from following such directives if they are consistent with accepted medical practice. Physician must immediately inform patient and family or guardian and shall not impede transfer to complying physician or health care facility; patient's medical records and information shall be supplied to receiving physician or facility Unlawful for any health care facility or licensing agency to discriminate against health care professional that is unwilling to comply with advanced directive of patient as long as he or she complies with notification and transfer provisions of act. Not subject to criminal prosecution or civil liability or deemed to have engaged in unprofessional conduct as a result of withholding or withdrawing life prolonging treatment in accordance with directive unless shown by preponderance of evidence that there was bad faith

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
LOUISIANA R.S. 40:1299.58.1 (c) et seq. Declarations Concerning Life-sustaining Procedures Any medical procedure or intervention, including but not limited to invasive administration of nutrition and hydration, which would serve only to prolong the dying process for a person diagnosed as having a terminal and irreversible condition. Does not include any measure necessary for comfort care The declaration made under statutory "Declarations Concerning Life-sustaining Procedures" may include designation of another person to make treatment decision for the declarant should s/he be diagnosed with terminal or irreversible condition and be comatose, incompetent or otherwise mentally or physically incapable of communication (sample form §1299.58.3 (c)) Revocable at any time by declarant without regard to mental state or competency by (1) destruction of document; (2) written revocation signed and dated by declarant; (3) oral or nonverbal expression by declarant of intent to revoke. Effective upon communication to physician Declaration properly executed in and under the laws of another states is deemed to be validly executed. Physician shall make reasonable effort to transfer patient to another physician Any health care facility, physician or other person acting under their direction shall not be criminally, civilly, or professionally liable for withholding life-sustaining procedures in accordance with the provisions of this chapter
MAINE 18A §5-501, et seq. Durable Power of Attorney; 18A 5-801 et seq. Consent or withhold consent or approval relating to any medical or other health care treatment of the principal including life-sustaining treatment when principal is in terminal condition or persistent vegetative state (1) Signed by principal or another at principal's direction; (2) 2 witnesses other than designated attorney-in-fact (unless prior to effective date of statute); (3) contains words to the effect that authority is exercisable not withstanding incapacity or disability (sample form §5-702(c)) May be revoked or terminated by a fiduciary of principal only with prior approval of court upon petition by any interested person Declaration executed in another state in compliance with laws of that state and Maine is valid Attending physician or other health care provider who is unwilling shall take all reasonable steps as promptly as practicable to transfer to another physician willing to comply. Willful failure to transfer is a Class E crime Physician or other health care provider whose action is in accord with reasonable medical standards and in good faith is not subject to criminal or civil liability or discipline for unprofessional conduct

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
MARYLAND Health-Gen. 5-601 et seq. Health Care Decisions Act Appointment by declarant under advance directive to make health care decisions for declarant under circumstances stated in directive based on wishes of declarant; decision regarding the provision, withholding of life-sustaining procedures should be based, in whole or in part, on the patients preexisting, long-term mental or physical disability or a patient's economic disadvantage; can't authorize sterilization or treatment for mental disorder (1) Voluntary; (2) dated and in writing; (3) signed by declarant or at express direction of declarant; (4) subscribed by 2 witnesses; (5) effective when attending physician and second physician certify in writing that patient is incapable of making an informed decision on basis of physical examination within 2 hours of certification (if patient is unconscious, second physician is not required); (6) communicated to physician who shall made it part of declarant's medical records Revocable at any time by (1) signed and dated writing; oral statement to health care practitioner; (3) execution of subsequent directive Declaration executed out-of-state by nonresident is effective if declaration is in compliance with the laws of Maryland or the laws of the state where executed (to the extent permitted by the laws of Maryland) Attending physician shall make every reasonable effort to transfer declarant to another health-care provider; assist in transfer; and pending transfer comply with competent individual or health-care agent/surrogate for person incapable of making a decision if failure to comply would likely result in death of individual Any health-care provider who withholds or withdraws health care or life-sustaining procedures in accordance with this subtitle and in good faith, is not subject to civil or criminal liability and may not be found to have committed professional misconduct

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
MASSACHUSETTS Ch. 201D §1, et seq. Health Care Proxies Any and all health care decisions on principal's behalf that principal could make including decisions about life-sustaining treatment (which do not include those procedures to provide comfort care or pain alleviation), subject to any express limitations of health care proxy's authority (proxy has priority over other persons, including one with durable power of attorney unless limited by principal or court order) (1) Competent adult; (2) in writing; (3) signed; (4) in presence and subscribed by 2 adult witnesses, that the principal appeared to be 18, of sound mind and under no constraint or undue influence; (5) Health care proxy must contain identities of principal and health care agent and indicate principal intends agent to have authority to make health care decisions on his behalf and describe any limitations and indicate agent's authority effective if it is determined that principal lacks decisional capacity Revocable by (1) notification of agent or health care provider orally or in writing or by any other act evidencing specific intent to revoke the proxy; (2) execution of subsequent health care proxy; (3) divorce or legal separation where spouse was principal's agent under health care proxy Effective if executed in another state or jurisdiction if in compliance with laws of that state or jurisdiction provided §14 and §15 of Chap. 201D are not violated (re: refusal to honor proxy) Physician should arrange for transfer of patient to equivalent facility "reasonably accessible" to patient's family; if unable to do so, physician shall seek judicial relief or honor agent's decision No civil, criminal, or professional liability for carrying out in good faith a health care decision by an agent pursuant to a health care proxy

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
MICHIGAN §700.5501 et seq. Uniform Durable Power of Attorney Act Designation may include statement of patient's desires on care, custody, and medical treatment decisions (effective only when patient is unable to participate in medical treatment decisions); may authorize patient advocate to exercise 1 or more powers concerning patient's care, custody, and medical treatment that patient could have exercised on own behalf. Patient advocate may make decision to withhold or withdraw treatment which would allow patient to die only if patient has expressed in a clear and convincing manner that patient advocate is allowed to do so and that patient acknowledges that such a decision would allow death (1) 18 yrs.; (2) sound mind; (3) signed in writing; (4) in the presence of and signed by 2 witnesses; (5) proposed patient advocate must sign acceptance; (6) executed voluntarily; (7) made part of patient's medical record before implementation; (8) exercisable only when patient is unable to participate in decisions; (9) cannot be used for pregnant patient (1) Revocable at any time and in any manner sufficient to communicate intent by patient to revoke; (2) resignation or removal of patient advocate; (3) subsequent designation that revokes prior designation, either expressly or by inconsistency; (4) divorce revokes designation of patient advocate in former spouse; (5) death of patient; (6) order of probate court; (7) occurrence of provision for revocation contained in designation; (8) any current desires of patient are binding on patient advocate   Physician or health care provider is bound by sound medical practice and instructions of patient advocate if patient advocate complies with law Person providing, performing, withholding, withdrawing medical treatment reasonably relying on decisions of patient advocate is liable in same manner and to same extent as if patient had made decision on his or her own behalf

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
MINNESOTA 145C.01, et seq. Health Care Directives Power to consent, refuse to consent, withdraw consent to any care, treatment, procedure or health care decision to maintain, diagnose, or treat mental or physical condition of principal including food and water by artificial means (1) signed by principal; (2) dated; (3) signed by 2 adult witnesses or acknowledged by principal before a notary public; (4) when inconsistencies arise between proxy, living will, or agent, most recently executed document takes precedence (suggested statutory form §145C.05) Divorce revokes any designation of former spouse as agent to make health care decisions. Revocable at any time by (1) destroying; (2) written statement expressing intent to revoke; (3) verbally expressing intent to revoke in presence of 2 witnesses; (4) executing subsequent instrument Power of attorney document, when executed in another state in compliance with that state's law is valid and enforceable in Minnesota to the extent it is consistent with Minnesota law Provider who has legal and actual capability of providing transfer and who is unwilling to provide directed health care may transfer patient to complying provider but must take all reasonable steps to provide directed health care until patient is transferred Health care provider not subject to criminal prosecution, civil liability or professional disciplinary action who relies in good faith on health care decision made by agent; no criminal, civil, or professional liability for health care provider who administers health care to keep patient alive (despite agent's decision) if all reasonable steps were promptly taken to transfer patient to complying provider

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
MISSISSIPPI 41-41-201, et seq. Uniformed Health-Care Decisions Act Consent, refuse consent, or withdraw consent to any care, treatment, service, or procedure to maintain, diagnose, or treat an individual's physical or mental condition; may include decisions after death such as anatomical gift, autopsy, etc. Does not affect health care treatment in an emergency (1) Durable power of attorney must specifically authorize the attorney-in-fact to make health care decisions; (2) dated; (3) witnessed by 2 individuals or notarized according to form set out in §41-41-159(b); (4) should follow substantially statutory form (§41-41-163) Unless the document provides a shorter time, it shall be effective until revoked by principal. Durable power of attorney revocable at any time the principal has capacity to give a durable power of attorney for health care by notifying the attorney-in-fact in writing or notifying the health care provider in writing or by executing subsequent valid durable power of attorney for health care (revokes prior durable power of attorney for health care)   Must promptly inform the patient of refusal and assist patient in being transferred to another institution No civil, criminal, or professional responsibility if health care provider relies in good faith on health care decision
MISSOURI 404.800, et seq. Durable Power of Attorney-for Health Care May make health care decisions, but no agent may authorize withdrawal of artificially supplied nutrition and hydration which the patient may ingest through natural means (1) Signed; (2) dated; (3) includes provision that durable power shall not terminate if principal becomes disabled or incapacitated; (4) powers generally commence upon certification by 2 licensed physicians that patient is incapacitated Revocable at any time in any manner by which patient is able to communicate the intent to revoke. Effective upon communication to agent or to physician   Physician may not impede the attorney-in-fact from transferring patient to another physician or facility Any third party acting in good faith may rely on the instructions of the attorney-in-fact without liability to the patient or the patient's successors-in-interest

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
MONTANA 50-9-101 et seq. Rights of the Terminally Ill Act Withholding or withdrawal of life-sustaining treatment, defined as any medical procedure or intervention that will serve only to prolong the dying process. Qualified patient may designate another individual to make decisions governing withholding or withdrawal of life-sustaining treatment. Life-sustaining procedures may not be withdrawn when qualified patient is known to be pregnant and when it is likely fetus will result in live birth (1) 18 yrs. and of sound mind; (2) signed by declarant or another at his request; (3) 2 witnesses; (4) communicated to physician and made part of patient's medical record; (5) declared to be terminal and no longer able to make decisions regarding life-sustaining treatment; (7) declarant may designate another individual, 18 yrs. old and of sound mind, to make decisions regarding life-sustaining treatment (sample form §50-9-103) Revocable at any time in any manner without regard to physical or mental condition. Effective upon notice Declaration made in another state in compliance with that state's laws executed in a substantially similar manner to laws of Montana is effective Unwilling physician shall take all reasonable steps as promptly as practicable to transfer to another who is willing Individual appointed under this section not criminally or civilly liable for decisions made pursuant to executed declaration; attending physician or health care provider not subject to civil or criminal liability or guilty of unprofessional conduct if acting in accordance with reasonable medical standards and in good faith.

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
NEBRASKA 30-3401et seq. Health Care Power of Attorney Consent, refusal of consent, withdrawal of consent to health care. Shall not include (1) withdrawal of routine comfort care; (2) withdrawal of usual and typical provision of nutrition and hydration; (3) withdrawal or withholding of life-sustaining procedures or artificially administered nutrition or hydration except if declarant gives that authority. (Note that an attempted suicide by the principal shall not be construed as indicating the principal's wishes with regard to health care.) (1) In writing; (2) identify parties; (3) specifically authorize attorney-in-fact to make decisions when principal is incapable (this must be documented by physician indicating cause and nature of incapacity); (4) signed and witnessed by 2 adults; (5) show date of execution; (6) substantially in form of §30-3408; (7) not operative when principal is known to be pregnant and live birth is probable Revocable at any time by competent principal in any manner he/she is able to communicate an intent to revoke; withdrawal at any time by attorney-in-fact. Otherwise, effective until death of principal; divorce or legal separation, unless otherwise noted in divorce decree, shall be deemed to revoke power of attorney for health care in spouse. Declaration executed in another state is valid according to its terms if valid under the laws of that state Unwilling physician shall inform attorney-in-fact and promptly assist in transferring principal to willing physician No criminal, civil, or professional liability if acting in good faith. Does not limit liability for negligence
NEVADA 449.800 et seq. Durable Power of Attorney for Health Care Attorney-in-fact has power to make health care decisions before or after death for disabled principal including consent, refusal of consent, or withdrawal of consent to any care, treatment, service, or procedure to maintain, diagnose, or treat physical or mental condition except treatment specifically stated: commitment to mental facility, convulsive treatment, psychosurgery, sterilization, or abortion or any other specifically designated treatments. (1) Signed; (2) notarized or 2 witnesses; (3) sample form: §449-613 to designate person to make decision re: life-sustaining treatment; §449-830 mandatory form to create durable power of attorney. Divorce revokes designation of former spouse. Power of attorney remains valid indefinitely unless principal designates shorter period or it is revoked or another power of attorney is executed subsequently.      

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
NEW HAMPSHIRE 137-J:1 et seq. Durable Power of Attorney for Health Care Document delegating health care decisions to agent; includes consent, refusal to consent or withdrawal of consent to any care, treatment, admission to a health care facility, any service or procedure to maintain, diagnose or treat an individual's physical or mental condition. Artificial nutrition and hydration may not be withdrawn or withheld unless clear expression of such power in document. Does not include power to consent to voluntary admission to state institution, voluntary sterilization or consent to withholding of life-sustaining treatment for pregnant patient unless treatment will not permit continuing development and live birth of unborn child. (1) In writing; (2) substantially statutory form; (3) 2 subscribing witnesses who affirm that principal appeared to be of sound mind and free from duress and that he was aware of the nature of the document and signed it voluntarily; (4) include disclosure statement in substantially same form as §137-J:14 prior to execution Revocable by (1) notifying attorney-in-fact or health care provider orally or in writing or in any other way communicating specific intent to revoke; (2) execution of subsequent durable power of attorney; (3) filing of action of divorce if spouse is agent. Revocation effective upon notice to health care provider or to attorney-in-fact. Person who is directly interested or related to patient may file an action to revoke durable power of attorney on grounds that principal was not of sound mind or under duress, fraud, or undue influence. Documents executed in another state are enforceable if they are in compliance with the law of that state or jurisdiction; foreign instruments are restricted to and must be in compliance with the laws of New Hampshire. Unwilling physician or health care provider must inform attorney-in-fact and allow for transfer of patient to another facility No person acting in good faith pursuant to durable power of attorney terms shall be subject to criminal or civil liability or unprofessional conduct. No liability for facility which refuses to carry out terms of agent's direction provided they informed agent of their refusal.

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
NEW JERSEY 26:2H-53, et seq. Advanced Directives for Health Care Decisions to accept or refuse treatment, service, or procedure used to diagnose, treat, or care for a patient's physical or mental condition including life-sustaining treatment. Includes decisions on acceptance or rejection of services of particular physician or health care provider or transfer of care; on the use of any medical device or procedure, artificially provided fluids and nutrition, drugs, surgery or therapy that uses mechanical or other artificial means to sustain, restore, or supplant a vital bodily function and thereby increase the expected life span of a patient; does not include provision of comfort care or alleviation of pain (1) Competent adult; (2) signed; (3) dated; (4) 2 witnesses who shall attest that declarant is of sound mind and free of duress and undue influence or notarized or other person authorized to administer oaths. May be supplemented by video or audio tape recording; (5) directive implemented when determination of lack of decision-making capacity is documented and confirmed by physicians Revocable by (1) oral or written notification; (2) execution of subsequent directive; (3) divorce revokes former spouse's designation as representative. Patient's clearly expressed wishes take precedent over any patient's decision or proxy directive Effective if executed in compliance with New Jersey law or the laws of that state. Effective if executed in a foreign country in compliance with that country's laws or the laws of New Jersey and is not contrary to public policy of New Jersey Unwilling physician should act as soon as practicable to effect an appropriate, respectful and timely transfer care and to assure patient is not abandoned or treated disrespectfully No civil, criminal, or professional liability for any physician acting in good faith and pursuant to this act

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
NEW MEXICO 24-7A-1 et seq. Uniform Health Care Decisions Act Agent has power of attorney for health care to make health care decisions including selection and discharge of health care providers, approval and disapproval of diagnostic tests, surgical procedures, programs of medication, orders not to resuscitate, and directions to provide, withhold or withdraw artificial nutrition and hydration and all others forms of treatment or health care which maintains, diagnoses, or otherwise affects an individual's mental or physical condition. (1) Adult or emancipated minor having capacity; (2) in writing; (3) signed by principal; (4) may include individual instructions; (5) effective upon determination that principal lacks capacity Individual with capacity may revoke by (1) signed writing; (2) personally informing supervising health care provider; (3) in any manner that communicates intent to revoke; (4) filing for divorce or legal separation revokes designation of spouse as agent (revived by remarriage); (5) conflicting earlier health care directive (to the extent of the conflict) Valid if it complies with provisions of Uniform Health Care Decisions Act regardless of where it was executed or communicated. Physicians or health care provider who declines to comply with health care decision must inform patient or agent; provide continuing care until a transfer can be effected, and make reasonable efforts to assist in transfer to willing health care provider or physician. No civil or criminal liability or discipline for unprofessional conduct if health care provider acting in good faith and in accordance with generally accepted health care standards in complying with provisions of this act.

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
NEW YORK Pub. Health Law §2980, et seq. Health Care Agent and Proxies Any decision to consent or refuse consent of any treatment, service, or procedure to diagnose or treat an individual's physical or mental condition (1) Competent adult; (2) signed; (3) dated; (4) 2 adult witnesses who shall sign proxy and state that principal appeared to execute proxy willingly and free from duress; (5) indicate that principal wants agent to make health care decisions for him; (6) agent's authority begins when it is determined that principal lacks capacity to make health care decisions (made by attending physician to a reasonable degree of medical certainty and in writing; case of decision to withhold or withdraw life-sustaining treatment another physician must confirm determination; (7) sample form §2981 (5) (d) Proxy may provide that it expires on a specified date or occurrence of condition; otherwise in effect until revoked. Revocable by (1) notifying agent or health care provider orally, in writing, or any other act evidencing intent to revoke; (2) divorce if former spouse was agent; (3) upon execution of a subsequent health care proxy Effective if executed in another state in compliance with laws of that state If agent's health care decision can not be honored, agent must be informed prior to admission if possible and transferred promptly to another hospital that is reasonably accessible under the circumstances and willing to honor agent's decision. Health care provider shall cooperate in facilitating such transfer. No criminal, civil, or professional liability for acting in good faith pursuant to statute

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
NORTH CAROLINA §32A-15 et seq. Health Care Powers of Attorney Decisions regarding life-sustaining procedures, including those which serve to artificially prolong the dying process and may include mechanical ventilation, dialysis, antibiotics, artificial nutrition and hydration and other forms of treatment which sustain, restore, or supplant vital bodily functions but do not include care necessary to provide comfort or alleviate pain (1) 18 yrs. old; (2) understanding and capacity to make and communicate health care decisions; (3) in writing; (4) signed in presence of 2 witnesses and acknowledged before a notary (suggested form §32A-25) May be revoked at anytime by principal capable of making and communicating health care decisions or by death of principal or by execution of a subsequent instrument or written instrument of revocation or any other method where intent to revoke is communicated (effective upon communication). Revoked on decree of divorce if spouse is agent, except if alternate has been appointed. If all health care attorneys-in-fact are unwilling or unable to act, the health care power of attorney will cease to be effective     No person acting on the authority of the health care attorney shall be liable for actions taken pursuant to decision of health care attorney. Withholding or discontinuing life-sustaining procedures shall not be considered suicide or cause of death for criminal or civil purpose.

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
NORTH DAKOTA 23-06.5-01 et seq. Durable Power of Attorney for Health Care Agent has power to make any health care decisions principal could if he did not lack capacity (lack of capacity must be certified in writing by principal's attending physician), decisions including consent, refusal to consent or withdrawal of consent or request any care, treatment, service, or procedure to maintain, diagnose, or treat individual's physical or mental condition; does not include admission to mental health facility, psychosurgery, abortion, or sterilization. (1) Signed; (2) 2 witnesses who affirm principal was of sound mind and signed it freely and voluntarily; (3) agent must accept appointment in writing; (4) statutory form of durable power of attorney (§23-06.5-17) is preferred format Revocable by (1) notification of agent orally, in writing, or any other act evidencing specific intent to revoke; (2) execution of subsequent durable power of attorney; (3) divorce where spouse was principal's agent Effective if executed in another state in compliance with the law of that state Physician has duty to inform principal or agent and take all reasonable steps to transfer care to another who is willing to honor agent's directive No civil, criminal, or professional liability if acting in good faith and with ordinary care pursuant to directives of durable power of attorney
OHIO 1337.11, et seq. Durable Power of Attorney for Health Care Medical procedure, treatment, intervention, or other measure that will serve to prolong the process of dying, including right to give informed consent and make other decisions principal could if s/he had capacity (1) Adult; (2) sound mind; (3) signed; (4) dated; (5) signed in presence of 2 adult witnesses or notarized (including attestation that principal is of sound mind and free from duress) Does not expire unless principal specifies an expiration date in the instrument. Revocable at any time in any manner; effective when expressed, but if physician had knowledge of the durable power of attorney, revocation is effective on communication to physician. Valid Durable Power of Attorney for health care revokes prior instrument Effective if document complies with the laws of the state where executed and that substantially complies with Ohio law Physician may not prevent or delay patient's transfer to another physician No civil, criminal, or professional liability for good faith reliance which is in accordance with reasonable medical standards on agent's health care decisions

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
OKLAHOMA Tit. 58 §1071, et seq.; Ch. 17A Uniformed Durable Power of Attorney Act Agent may grant complete or limited authority to make health and medical care decisions but not life-sustaining treatment decisions unless the power complies with requirements for a "health care proxy" under Oklahoma Rights of Terminally Ill or Persistently Unconscious Act, Tit. 63 §3101 et seq. (1) Signed; (2) 2 adult witnesses who sign in the presence of the principal and each other; (3) substantially the same form as Tit. 58 §1072.2 (4)(3) Revocable in whole or in part in any manner at any time without regard to declarant's mental or physical condition. Effective upon communication to physician Effective if executed in another state if substantially complies with the Uniform Durable Power of Attorney Act Physician shall take all reasonable steps to arrange for care by another physician No civil, criminal, or professional liability for carrying out the directives of durable power of attorney in good faith and in accordance with reasonable medical standards
OREGON 127.505 et seq. Advanced Directives for Health Care & 127.800 Death With Dignity Act Power to make health care decisions for principal regarding life-sustaining procedures including any medical procedure or intervention that uses mechanical or other artificial means to sustain, restore, or supplant a vital function only when authorized or when principal is terminally ill and such treatment only serves to artificially prolong the moment of death; does not include procedures to sustain patient cleanliness and comfort (1) In writing; (2) signed by two witnesses who make written declarations; (3) mandatory statutory form §127.531 ORS; (4) agent must accept appointment Agent may withdraw up to time of principal's incapacity. Principal may revoke (1) in any manner by which s/he is able to communicate to health care provider or attorney-in-fact intent to revoke; (2) by execution of subsequent durable power of attorney; (3) upon divorce if spouse is agent Valid execution in compliance with formalities of that state where principal is resident or is located or with state of Oregon Physician must promptly notify health care representative if unable or unwilling to comply with durable power of attorney and representative shall make a reasonable effort to transfer the principal to a complying physician Health care provider acting on a durable power of attorney or health care agent in good faith is not liable for criminal, civil, or professional disciplinary actions
PENNSYLVANIA 20 Pa CSA §5601-5604 Powers of Attorney Authorize admission to medical facility and enter into agreements for principal's care and to consent, arrange, and authorize medical and surgical procedures including administration of drugs (1) In writing; (2) signed; (3) in the presence of 2 witnesses; (4) presumed durable Durable power of attorney not affected by subsequent disability or incapacity. Agent must have actual notice of revocation for it to be effective. Divorce revokes power of attorney for spouse. Documents executed in other states valid except to extent they allow agents to make decisions inconsistent with Pennsylvania law   Person acting in good faith reliance on power of attorney shall incur no liability as a result.

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
RHODE ISLAND 23-4.10-1, et seq. Health Care Power of Attorney Any medical procedure or intervention that will only prolong the dying process; it shall not include intervention necessary to alleviate pain or provide comfort (1) 18 yrs.; (2) resident of Rhode Island; (3) 2 adult witnesses; (4) only in statutory form set forth in §23-4.10-2; (5) no effect or force to document if patient is pregnant and live birth is probable with continued application of treatment Revocable at any time in any manner declarant is able to communicate intent to revoke, without regard to physical or mental condition. Effective upon communication to physician. Controls over living will executed by same person for any inconsistent provisions Durable power of attorney executed in another state in compliance with laws of that state is valid Unwilling physician must make necessary arrangements to effect transfer to complying physician No civil, criminal, or professional liability when acting in accordance with the statute and in accordance with reasonable medical standards.
SOUTH CAROLINA 62-5-501, et seq. Powers of Attorney Medical procedure or intervention serving only to prolong the dying process, not including medication or treatment for pain alleviation or comfort care. Principal should indicate whether provision of nutrition and hydration through surgically implanted tubes is desired (1) Substantially in statutory form §62-5-504 (D); (2) signed; (3) dated; (4) 2 witnesses; (5) state name and address of adult agent; (6) can't withhold or withdraw life-sustaining procedures during pregnancy Revocable by (1) written or oral statement or other act constituting notification to agent or health care provider of specific intent to revoke; (2) principal's execution of subsequent health care power of attorney Effective if executed in compliance with South Carolina law or laws of another state and recorded as required by §62-5-501 (c) Physician must make reasonable effort to locate a physician who will follow directive and has a duty to transfer patient to that physician. No civil, criminal, or professional liability for relying in good faith on agent's health care decisions
SOUTH DAKOTA 59-7-2.1, et seq. Termination of Agency Any health care decisions for principal which principal could have made if s/he had decisional capacity including rejection or withdrawal of consent for medical procedures, treatment, or intervention. Agent may not authorize withholding artificial nutrition and hydration for comfort care or pain relief. Artificial nutrition or hydration may be withheld under certain circumstances or if specifically authorized. Specific intent must be included in document for durable power of attorney to extend even when principal is disabled but life-sustaining treatment must be given to a pregnant woman unless live birth unlikely to a reasonable degree of medical certainty. Revocation must be recorded with register of deeds     No civil, criminal, or professional liability for physician acting in good faith on a health care decision by agent or attorney-in-fact

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
TENNESSEE 34-6-201, et seq. Durable Power of Attorney for Health Care Act Any procedure, treatment to diagnose, assess, or treat a disease, illness, or injury, including surgery, drugs, transfusions, mechanical ventilation, dialysis, CPR, artificial nourishment, hydration or other nutrients, radiation. Death by starvation or dehydration allowed only if specifically directed with statutory phrase. Signed before 2 witnesses and notary public and specifically authorizes health care decisions Revocable by (1) notifying the attorney-in-fact orally or in writing; (2) notifying health care giver orally or in writing; (3) executing subsequent durable power of attorney; (4) divorce if former spouse was designated; (5) principal's current wishes supersede durable power of attorney Effective if document complies with laws of Tennessee or laws of the state of principal's residence Prompt and orderly transfer required No criminal, civil, or professional liability for physician acting in good faith
TEXAS Health & Safety Code §166.151, et seq. Durable Power of Attorney for Health Care Decisions regarding consent to health care, treatment, service, or procedure to maintain, diagnose, or treat individual's physical or mental condition. Agent may not consent to voluntary in-patient mental health services, convulsive treatment, psychosurgery, abortion, or neglect of principal through omission of care primarily intended to provide for comfort of principal (1) Signed; (2) in presence of 2 or more subscribing witnesses; (3) substantially statutory to form §135.015 and .016) and accompanied by disclosure statement. Principal may designate alternative agents Effective indefinitely upon execution and delivery of document unless revoked. Revocable orally or in writing with specific intent to revoke or execution of subsequent power of attorney; divorce if spouse is agent. Effective upon receipt and notice to agent and health care provider. Durable power of attorney executed in another state valid if it complies with the law of that state or jurisdiction Physician must notify agent immediately to arrange for transfer Agent not liable for health care decision made in good faith. Physician not liable for acts or decisions made under durable power of attorney if done in good faith and does not constitute a failure to exercise due care in the provision of health care services

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
UTAH 75-2-1106 Special Power of Attorney; 75-2-1101 et seq. Personal Choice and Living Will Act Any medical procedure or intervention that would serve only to prolong the dying process including artificial nutrition and hydration unless declaration specifically excludes; does not include medication, sustenance, or any procedure to alleviate pain; separate procedure for "do not resuscitate" directive. Agent/proxy:(1) 18 yrs.; (2) in writing; (3) dated and signed; (4)suggested form §75-2-1105. For power of attorney: must be before notary public and the suggested form is §75-2-1106; power of attorney takes precedent over earlier signed directives Current wishes of declarant take precedent over any directive. Revocable at any time by (1) signed revocation; (2) destruction of document; (3) oral expression of intent to revoke in presence of witness. Effective on receipt by physician A similar instrument executed in another state is presumed to comply with Utah law and may be relied upon in good faith. Unwilling physician required to transfer patient promptly No civil, criminal, or professional liability for good faith compliance with directive
VERMONT Tit. 14 §3451, et seq. Durable Power of Attorney for Health Care To make health care decisions for principal during periods of incapacity as certified in writing by principal's attending physician including withdrawal of consent to any care, treatment, service, or procedure or to maintain, diagnose, or treat an individual's physical or mental condition; does not include consent to sterilization or admission to state institution (1) Signed; (2) 2 witnesses; (3) signed statement that principal understands a disclosure statement on durable powers of attorney; (4) substantially same form as §3466 Principal's current wishes supersede directives at all times. Revocable by (1) notifying agent or health care provider orally or in writing or any other act evidencing specific intent to revoke; (2) executing a subsequent durable power of attorney; (3) divorce, if former spouse was principal's agent Effective if in compliance with the law of the state in which it was executed Unwilling physician must inform agent and principal if possible and assist in selecting another physician willing to honor agent's directive No civil, criminal, or professional liability if physician acts in good faith; no immunity for failure to exercise due care in provision of services

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
VIRGINIA 54.1-2981 Health Care Decisions Act Any medical procedure, treatment, intervention, utilizing mechanical or other artificial means to sustain, restore, or supplant a vital function, or is of a nature to afford patient no reasonable expectation of recovery from a terminal condition and when applied to a patient in terminal condition, would serve only to prolong the dying process. Includes artificially administered hydration and nutrition and CPR by emergency medical services personnel, but does not include any medication or procedure to alleviate pain or provide comfort care (1) Competent adult; (2) written advance directive; (3) signed in presence of 2 subscribing witnesses; (4) oral declaration in presence of physician and 2 witnesses for those in terminal condition; (5) responsibility of declarant to provide notification of advance directive to attending physician. (suggested form §54.1-2984)) Revocable at any time by (1) signed, dated writing; (2) physical cancellation or destruction; (3) oral expression of intent to revoke. Effective upon communication to attending physician Directive executed in another state valid if in compliance with Virginia law or law of state where executed. Such directives shall be construed in accordance with Virginia laws If physician thinks treatment is medically or ethically inappropriate or is contrary to terms of advanced directive, unwilling physician must make reasonable effort to transfer patient to another physician No civil, criminal, or professional liability if acting in good faith. It would have to be shown by preponderance of the evidence that the person authorizing life-prolonging procedures acted in bad faith
WASHINGTON 11.94.010, et seq. Power of Attorney Appointed attorney-in-fact may make health care decisions on principal's behalf or provide informed consent (1) In writing; (2) principal designates another as his attorney-in-fact; must include words showing intent of principal that authority be conferred notwithstanding principal's disability Continues until revoked or terminated by principal, court-appointed guardian or court order     Anyone acting in good faith and without negligence shall incur no liability

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
WEST VIRGINIA §16-30-1, et seq. Health Care Decisions Act To affect a patient's decision to accept or reject medical or surgical treatments which prolong the dying process artificially (1) 18 yrs.; (2) in writing; (3) signed by declarant or someone at his or her directive; (4) dated; (5) 2 witnesses; (6) notarized; (7) with words indicating effective upon patient's incapacity; substantially same form as §16-30A-18 Desires of principal at all times supersede effect of medical power of attorney. Revocable at any time by (1) destruction of document; (2) written revocation signed and dated; (3) verbal expression with witness present; (4) divorce if former spouse was designated Valid if in compliance with laws of West Virginia or state where executed and expressly delegates health care decisions Unwilling physician shall cause the transfer of principal to a complying physician No criminal civil liability for good faith compliance with directions of medical power of attorney or representative
WISCONSIN 155.01 et seq. Power of Attorney for Health Care Designation of another for purpose of making informed decisions in the exercise of the right to accept, maintain, discontinue, or refuse any care, treatment, service or procedure to diagnose, maintain, or treat physical or mental condition. Feeding tube may be withheld or withdrawn unless it would cause pain. Agent may not consent to withholding or withdrawing of orally ingested nutrition or hydration unless provision is medically contraindicated (1) 18 yrs. and sound mind; (2) in writing; (3) signed; (4) dated; (5) 2 witnesses; (6) voluntarily executed; (7) takes effect upon finding of incapacity by 2 physicians; (8) substantially same form as §155.30; (9) may file with register in probate Revocable at any time by (1) canceling or destroying document; (2) revocation in writing signed and dated; (3) verbal revocation in presence of 2 witnesses; (4) executing a subsequent power of attorney; (5) divorce if former spouse was attorney-in-fact.   Must make good faith attempt to transfer principal to complying physician. No civil, criminal, or professional liability if acting in good faith

Table 37a: Right to Die: Durable Power of Attorney—Continued

State/Code Section Specific Powers, Life-Prolonging Acts Operative Facts Revocation/Duration Reciprocity Transfer of Patient if Physician Unwilling Immunity for Attending Physician
WYOMING 3-5-201, et seq. Durable Power of Attorney for Health Care Consent, refusal of consent, or withdrawal of consent to any medical procedure, care, treatment, intervention, or nourishment by artificial means in the event of a terminal condition except for alleviation of pain and comfort care and consent to convulsive treatment, psychosurgery, or commitment to mental facility; does not affect health care treatment in an emergency (1) Signed; (2) dated; (3) 2 witnesses; (4) notarized; (5) attorney-in-fact authorized to make health care decisions Principal's wishes if able to give informed consent take precedent over durable power of attorney. Revocable by (1) notifying attorney-in-fact in writing; (2) notifying health care provider in writing; (3) divorce if former spouse was attorney-in-fact; (4) a subsequent valid durable power of attorney for health care     No criminal, civil, or professional liability if acting in good faith
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