How do I … complete my free Durable Power of Attorney for Healthcare form?

National Healthcare Decisions Day is April 16, and The Missouri Bar offers Durable Power of Attorney for Health Care and Health Care Directive form free online. Here are answers to six frequently asked questions to help you complete your form; the form also contains a FAQ section.  

Do I need a lawyer to complete this Durable Power of Attorney for Health Care and/or Health Care Directive form? 

No. If you do not feel that this form meets your needs or if you have questions, you may want to consult a lawyer. If you have questions about medical care and treatment, your physician, social workers, registered nurses, and other health care providers also may be able to answer your questions. 

Do I need both a Durable Power of Attorney for Health Care and a Health Care Directive? 

This is your choice. If you want someone to speak for you concerning your future medical care and treatment, you need to appoint an agent to do so in the Durable Power of Attorney (Part 1). Please do Part 1 if you have someone in mind to appoint. If you only want to name a decision-maker without including directions to follow in making decisions, then complete parts 1 and 3 without Part 2. 

What are the requirements for a person to serve as my agent? 

You may select a person 18 years old or older who has the mental capacity to make these decisions. Your agent is usually a close relative or friend that you trust to respect and advocate for your case and treatment preferences. The agent cannot be your doctor or an owner/operator or employee of a health care facility where you are a patient or resident, unless you are related to that person. 

When can my agent act? 

The Durable Power of Attorney for Health Care (Part 1) only becomes effective for making health care decisions when you are determined to be incapacitated and unable to make health care decisions yourself. the form enables you to choose whether you want one physician or two to determine if you lack capacity to make health care decisions. Unless you indicate otherwise, Missouri law requires two physicians to make this determination about incapacity. Some other powers take effect immediately without a finding of incapacity. 

Does the authority of my agent under my Durable Power of Attorney for Health Care end at my death? 

Yes, with a few exceptions. You can give your agent the following special powers to act for you after you die: to choose and control the burial, cremation, or other final disposition of your remains (called the “right of sepulcher”); to consent to an autopsy; and to delegate the health care decision making to another person. You can also give your agent the power to consent to or prohibit anatomical gifts of organs or tissue.  

What is the difference between an Out-Of-Hospital Do-Not-Resuscitate (OHDNR) Order and a health care directive? 

The OHDNR Order is a physician’s order under Missouri law that the patient will not be resuscitated (usually through CPR) if the patient stops breathing or the patient’s heart stops, typically in a non-hospital setting by EMS or other emergency first-responders who may be called. This order must be signed by a physician and the patient (or if the patient lacks capacity, the patient’s agent under a health care durable power of attorney or the patient’s guardian). EMS and other emergency first-responders cannot follow your preferences as expressed in your health care directive because it is not a physician order. A health care directive states the patient’s choices about several types of treatment if certain conditions happen in the future. 

After I complete the Durable Power of Attorney for Health Care (Part 1) and/or the Health Care Directive (Part 2), do I need to do anything else? 

You should do several things after you have completed the form.  

1. Give copies to your agent, physician, and any other health care provider. 

2. Discuss your choices with your agent, physicians, and family and friends. 

3. Review your form to keep it up to date and remind your agent, physicians, and family and friends of your choices periodically. 

It is especially important to discuss your end-of-life treatment wishes as expressed in your Health Care Directive because Missouri law allows a health care provider (physician, hospital, etc.) to not follow your preferences if they have strongly held religious beliefs or moral convictions that are contrary to your wishes. If this is the case, they must offer to transfer your care to a health care provider who will honor your end-of-life treatment wishes, but you need to know if your physician will honor your wishes. If you become incapacitated and unable to make health care decisions for yourself and are unable to express your wishes, your agent needs to have this conversation with your physician. 

To learn more about NHDD and how you can complete your Durable Power of Attorney for Health Care and Health Care Directive form, go to MissouriLawyersHelp.org.