The Minnesota Health Care Directive Page 5
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• You are related to that person by blood, marriage, adoption, or registered domestic
partnership OR
• You state why you want that person to serve as your health care agent (complete
section on page two)
Powers of Agent
• Minnesota law allows your agent to make the same types of health care decisions that
you would be able to make.
• In addition, you may want to give your agent power over some related health care
decisions. Initial the line in front of each statement if you want your agent to have the
power explained. Your health care agent is NOT automatically given these powers.
Minnesota law has changed. You are now able to have your agent make
decisions for you even when you are able to make and communicate your
own health care decisions. You can do this if you would prefer to have
someone else make your health care decisions. If you want to do this initial
the appropriate box in the “additional powers of my agent” section.
Minnesota law assumes that if you name your spouse or registered domestic
partner as an agent you would NOT want that individual to continue as your
health care agent if a dissolution, annulment, or termination of the
relationship is in process or has been completed.
• You may limit the powers you want your agent to have. Use the space provided
(page 3). You should carefully consider the effect of limiting your agent’s powers
on his/her ability to make informed decisions regarding your care.
Part II: Leave Health Care Instructions
Why Leave Instructions?
• If you did not appoint an agent in Part I, you MUST leave some instructions in Part II
for your health care directive to be valid.
• Leaving instructions helps make sure that decisions are based on your values,
preferences, and wishes. While making health care decisions is never easy, knowing
what a person does or does not want helps decision makers feel as if they are making
the “right” decisions.
How to Leave Instructions
DO leave instructions which help others understand your health care goals, fears,
concerns, and what you want as well as do not want. It is impossible to predict what
specific types of health care decisions might be needed.
These materials were developed by a group of professionals with expertise in law,
health care, life and death health care decision making, and plain language materials
development with the leadership of Marlene S. Stum, PhD, University of Minnesota
Extension Service. (Updated 2008)
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