durable power of attorney for health care

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Related to durable power of attorney for health care: living will, Advance Medical Directives

advance directives

instructions about a person's wishes, goals, and values regarding what will be done in case he or she becomes incapable of making decisions about medical care; called also living will, durable power of attorney for health care, and sometimes advance health care directives or health care advance directives.

A proxy directive designates another person to make decisions; an instruction directive provides instructions about the person's values and goals or treatment preferences; a combined directive can do both. An instruction directive should focus on goals and values more than on specific medical interventions; interventions can be good in some situations and undesirable in others.

Formal directives are signed and legally authorized written documents. Informal directives are oral communications with family, significant other, or health care provider. Advantages of formal directives are: (1) they are preferences and values more likely to have been carefully considered; (2) they reflect more accurately a person's preferences; (3) they invoke legal practice that commits health care providers to a course of action; and (4) they provide legal enforcement for a person's preferences. Disadvantages include: (1) relatively few people make them or leave explicit directions; (2) identified decision makers might not be available, might be incompetent to make good decisions, or might have a conflict of interest; (3) some people change their preferences regarding treatment but fail to change their directives (and a few, when legally incompetent, protest a surrogate's decision); (4) state laws often severely restrict the use of advance directives; (5) professionals have no basis to overturn instructions that are against the patient's best medical interests, even though the patient might have formulated the instructions without foreseeing a given situation; and (6) some patients do not have an adequate understanding of the decision making needed, or even with an adequate understanding, cannot foresee all clinical situations. Because of inadequate counseling or imprecise language, documents may reflect uninformed preferences.

People often have difficulty identifying decisions and questions delineating adequately the full range of situations that may occur. Because of this, designation of surrogates has become more prevalent. The document can be used for refusal of life sustaining treatment.


1. capability; the ability to act.
2. the ability of a statistical test to detect statistically significant differences when they exist.
durable power of attorney for health care advance directives.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.
References in periodicals archive ?
(101.) Durable Power of Attorney for Health Care & Health Care Directive, Mo.
In some states, the durable power of attorney for health care is a separate legal document, and requires more formality in execution than the durable power for management of property requires.
A durable power of attorney for health care allows individuals to appoint someone to act on their behalf in making health-care decisions that do not necessarily involve terminating life-support measures.
In the absence of such a durable power of attorney for health care, the health care officials will turn to your blood relatives to make these decisions.
So, even if a durable power of attorney has been established, some states may require that the principal establish a durable power of attorney for health care.
Refusal of heroic measures and requests for withdrawal of life support are being blatantly ignored, sometimes even in the face of living wills and the instructions of the patient's designated durable power of attorney for health care. Our worst fears were confirmed in a recent study reported in the Journal of the American Geriatrics Society, conducted by doctors Joan Teno and Joanne Lynn at the George Washington University Center to Improve Care for the Dying and by their colleagues at seven other medical centers.
In many states, a durable power of attorney for health care is a signed, dated, and witnessed paper naming another person, such as a husband, wife, daughter, son, or close friend, as your authorized spokesperson to make medical decisions for you if you should become unable to make them for yourself.
The Patient Self-Determination Act defines "advance directive" as "a written instruction, such as a living will or durable power of attorney for health care, recognized under state law .
Mr Johnson's five children were also present, one of whom held a durable power of attorney for health care for Mr Johnson.
For example, many lawyers recommend that, when setting up a living will, you designate a health-care surrogate, someone to whom you have given what is called durable power of attorney for health care. This person is granted the authority to make medical decisions for you should you become unable to do so yourself.