Form Rev 133c7e0 - Pa Power Of Attorney For My Health Care - Medical Power Of Attorney Page 6
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6GENERAL INSTRUCTIONS
WHAT SHOULD BE INCLUDED
A Medical Power of Attorney should generally
WHAT IS A MEDICAL POWER OF
address the following:
ATTORNEY?
· Who do you trust to make healthcare
decisions for you
A Power of Attorney for Health Care allows
· What kind of decisions can your health
you to name a health agent, someone who
care agent make on your behalf
will make health decisions for you if you
· When can your health care agent begin
cannot. Your health care agent will ensure
making medical decisions for you
that your health care providers give you the
· Why you prefer to continue or discontinue
care you wish to receive. You can also
artificial life sustaining treatment
require
that
your
health
care
agent
communicate in any manner with you about
You can specify whether you health care
any specific proposed health care.
agent can make these additional decisions on
your behalf:
WHEN IS IT NEEDED?
· Mental Health Treatment
A Medical Power of Attorney or POAs are
Admit you into an institution for mental
-
commonly used when someone wants the
diseases or state treatment facility
peace of mind that their health decisions will
Give consent to experimental mental
-
be made by someone they trust. The Health
health research or psychosurgery
Care Agent steps into your shoes and can
access your medical information and make
· Nursing Homes
decisions on your behalf.
Admit you into a nursing home
-
Admit you into a community-based
-
You may need a Medical POA if you are:
residential facility
· Over the age of 18 years old
·
Military
personnel
being
deployed
· Feeding Tubes
overseas
Withhold or withdraw a feeding tube
-
· Traveling abroad for an extended time
· Diagnosed with a chronic condition or life
· Pregnant Women
threatening illness
Health care agent may or may not make
· Growing wiser and older but concerned
-
healthcare decisions for you if they know
about your current health
you are pregnant
· Married and want your spouse to have
legal authority over property you own
· Participate in extreme sports or activities
· Medical Records
that put your health at risk
Request, receive, and review all medical
-
· Engaged in a high risk profession (i.e.
records
firefighter or member of police force)
Grant medical releases
-
Consent to disclosure of info
-
OTHER NAMES
· Medical Treatment
Initiate or withhold a procedure
People may call a Medical POA by:
-
Start or stop a medical service
· Advance Medical Directive
-
Modify medical care
· Durable Power of Attorney for Health
-
Employ and discharge healthcare
Care
-
personnel
· Health Care Advance Directive
· Health Care Power of Attorney
· Health Care Proxy
· Anatomical Gifts
· Medical Durable Power of Attorney
Arrange or prohibit organ donations or
-
· Power of Attorney for Health Care
donate your body
Medical Power of Attorney (Rev. 133C7E0)
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