Durable Power Of Attorney For Health Care Template Page 2
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11INTRODUCTION
YOUR RIGHTS
Adults have the fundamental right to control the decisions relating to their health care. You have
the right to make medical and other health care decisions for yourself so long as you can give
informed consent for those decisions. No treatment may be given to you over your objection at
the time of treatment. You may decide whether you want life sustaining procedures withheld or
withdrawn in instances of a terminal condition.
What is a Durable Power of Attorney for Health Care?
This Durable Power of Attorney for Health Care lets you appoint someone to make health care
decisions for you when you cannot actively participate in health care decision making. The
person you appoint to make health care decisions for you when you cannot actively participate in
health care decision making is called your agent. The agent must act consistent with your desires
as stated in this document or otherwise known. Your agent must act in your best interest. Your
agent stands in your place and can make any health care decision that you have the right to make.
You should read this Durable Power of Attorney for Health Care carefully. Follow the
witnessing section as required. To have your wishes honored, this Durable Power of Attorney
for Health Care must be valid.
REMEMBER
i You must be at least eighteen (18) years old.
i You must be a Rhode Island resident.
i You should follow the instructions on this Durable Power of Attorney for Health Care.
i You must voluntarily sign this Durable Power of Attorney for Health Care.
i You must have this Durable Power of Attorney for Health Care witnessed properly.
i No special form must be used but if you use this form it will be recognized by health care providers.
i Make copies of your Durable Power of Attorney for Health Care for your agent, alternative
agent, physicians, hospital, and family.
i Do not put your Durable Power of Attorney for Health Care in a safe deposit box
.
i Although you are not required to update your Durable Power of Attorney for Health Care,
you may want to review it periodically.
Commonly Used Life-Support Measures Are Listed on the Back Inside Page
i
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