Illinois Statutory Short Form Power Of Attorney For Health Care printable pdf download

Illinois Statutory Short Form Power of Attorney for Health Care

NOTICE TO THE INDIVIDUAL SIGNING

THE POWER OF ATTORNEY FOR HEALTH CARE

No one can predict when a serious illness or accident might occur. When it does, you may need

someone else to speak or make health care decisions for you. If you plan now, you can increase

the chances that the medical treatment you get will be the treatment you want.

In Illinois, you can choose someone to be your “health care agent”. Your agent is the person you

trust to make health care decisions for you if you are unable or do not want to make them

yourself. These decisions should be based on your personal values and wishes.

It is important to put your choice of agent in writing. The written form is often called an “advance

directive”. You may use this form or another form, as long as it meets the legal requirements of

Illinois. There are many written and on-line resources to guide you and your loved ones in having

a conversation about these issues. You may find it helpful to look at these resources while

thinking about and discussing your advance directive.

WHAT ARE THE THINGS I WANT MY HEALTH CARE AGENT TO KNOW?

The selection of your agent should be considered carefully, as your agent will have the ultimate

decision making authority once this document goes into effect, in most instances after you are no

longer able to make your own decisions. While the goal is for your agent to make decisions in

keeping with your preferences and in the majority of circumstances that is what happens, please

know that the law does allow your agent to make decisions to direct or refuse health care

interventions or withdraw treatment. Your agent will need to think about conversations you have

had, your personality, and how you handled important health care issues in the past. Therefore, it

is important to talk with your agent and your family about such things as:

(i) What is most important to you in your life?

(ii) How important is it to you to avoid pain and suffering?

(iii) If you had to choose, is it more important to you to live as long as possible, or to avoid

prolonged suffering or disability?

(iv) Would you rather be at home or in a hospital for the last days or weeks of your life?

(v) Do you have religious, spiritual, or cultural beliefs that you want your agent and others to

consider?

(vi) Do you wish to make a significant contribution to medical science after your death through

organ or whole body donation?

(vii) Do you have an existing advanced directive, such as a living will, that contains your specific

wishes about health care that is only delaying your death? If you have another advance directive,

make sure to discuss with your agent the directive and the treatment decisions contained within

that outline your preferences. Make sure that your agent agrees to honor the wishes expressed in

your advance directive.

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Illinois Statutory Short Form Power Of Attorney For Health Care