Illinois Statutory Short Form Power Of Attorney For Health Care (Page 2 of 7) in pdf

Illinois Statutory Short Form Power Of Attorney For Health Care Page 2

WHAT KIND OF DECISIONS CAN MY AGENT MAKE?

If there is ever a period of time when your physician determines that you cannot make your own

health care decisions, or if you do not want to make your own decisions, some of the decisions

your agent could make are to:

(i) talk with physicians and other health care providers about your condition.

(ii) see medical records and approve who else can see them.

(iii) give permission for medical tests, medicines, surgery, or other treatments.

(iv) choose where you receive care and which physicians and others provide it.

(v) decide to accept, withdraw, or decline treatments designed to keep you alive if you are near

death or not likely to recover. You may choose to include guidelines and/or restrictions to your

agent's authority.

(vi) agree or decline to donate your organs or your whole body if you have not already made this

decision yourself. This could include donation for transplant, research, and/or education. You

should let your agent know whether you are registered as a donor in the First Person Consent

registry maintained by the Illinois Secretary of State or whether you have agreed to donate your

whole body for medical research and/or education.

(vii) decide what to do with your remains after you have died, if you have not already made plans.

(viii) talk with your other loved ones to help come to a decision (but your designated agent will

have the final say over your other loved ones).

Your agent is not automatically responsible for your health care expenses.

WHOM SHOULD I CHOOSE TO BE MY HEALTH CARE AGENT?

You can pick a family member, but you do not have to. Your agent will have the responsibility to

make medical treatment decisions, even if other people close to you might urge a different

decision. The selection of your agent should be done carefully, as he or she will have ultimate

decision-making authority for your treatment decisions once you are no longer able to voice your

preferences. Choose a family member, friend, or other person who:

(i) is at least 18 years old;

(ii) knows you well;

(iii) you trust to do what is best for you and is willing to carry out your wishes, even if he or she

may not agree with your wishes;

(iv) would be comfortable talking with and questioning your physicians and other health care

providers;

(v) would not be too upset to carry out your wishes if you became very sick; and

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Illinois Statutory Short Form Power Of Attorney For Health Care Page 2