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The Wisconsin Advance Health Care Directive is any written instructions concerning the making of medical treatment decisions on
behalf of the person who has provided the instructions. The Wisconsin State Statutes (chapter 154.03) created two forms of advance
directives for health care – the Declaration to Physicians also known as a Living Will and a Power of Attorney for Health Care.
Legal Helpmate® provides you with two options
1) The Premium Package - Wisconsin Advance Health Care Directive contains the following documents:
- Wisconsin Declaration to Physicians (Living Will) with organ donation provision
- Wisconsin Power of Attorney for Health Care
- Durable Springing Power of Attorney for Property and Finance
2) The Basic Package - Wisconsin Advance Health Care Directive contains the following documents:
- Wisconsin Declaration to Physicians (Living Will) with organ donation provision
- Wisconsin Power of Attorney for Health Care
LIVING WILL DECLARATION
The Wisconsin Declaration to Physicians is designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes known because of illness or injury. These wishes are usually based on personal values.
The Living Will Declaration means a written, witnessed document voluntarily executed by the Declarant under State law but is not limited in form or substance to that provided in State Statute.
The withholding or withdrawal of any medication, life-sustaining procedure or feeding tube may not be made if the attending physician advises that doing so will cause pain or reduce comfort and the pain or discomfort cannot be alleviated through pain relief measures.
You are responsible for notifying your attending physician of the existence of the declaration. An attending physician who is notified shall make the declaration part of your medical records. A declaration that is in its original form or is a legible photocopy or electronic facsimile copy is presumed to be valid.
Procedures for signing Declarations
A declaration must be signed by the declarant in the presence of 2 witnesses. Witnesses must be at least 18 years of age, not related to you by:
- blood,
- marriage or adoption and
- not directly financially responsible for your health care,
- a health care provider who is serving you at the time the document is signed,
- an employee of the health care provider, other than a chaplain or a social worker, or an employee, other than a chaplain or social worker, of an inpatient health care facility in which you are a patient.
Witnesses may also not be persons who know they are entitled to or have a claim on any portion of your estate.
If the declarant is physically unable to sign a declaration, the declaration must be signed in the declarant’s name by one of the witnesses or some other person at the declarant’s express direction and in his or her presence; such a proxy signing shall either take place or be acknowledged by the declarant in the presence of 2 witnesses.
Effect of Declaration
The desires of a qualified patient who is competent supersede the effect of the declaration at all times. If a qualified patient is incompetent at the time of the decision to withhold or withdraw life-sustaining procedures or feeding tubes a declaration executed under this chapter is presumed to be valid.
Revocation of Declaration
The Wisconsin Declaration to Physicians may be revoked at any time by the declarant by any of the following methods:
- By being canceled, defaced, obliterated, burned, torn or otherwise destroyed by the declarant or by some person who is directed by the declarant and who acts in the presence of the declarant.
- By a written revocation of the declarant expressing the intent to revoke signed and dated by the declarant.
- By a verbal expression by the declarant of his or her intent to revoke the declaration, but only if the declarant or a person acting on behalf of the declarant notifies the attending physician of the revocation.
- By executing a subsequent declaration.
If you have both a Declaration to Physicians and a Power of Attorney for Health Care, the provisions of a valid Power of Attorney for Health Care supersede any directly conflicting provisions of a valid Declaration to Physicians.
You should make relatives and friends aware that you have signed the document and the location where it is kept. A signed form may be kept in a safe, easily accessible place until needed. The document may but is not required to be filed for safekeeping, for a fee, with the register in probate of your county of residence. The fee for this has been set by State Statute at $8.00.
POWER OF ATTORNEY FOR HEALTH CARE
The Wisconsin Power of Attorney for Health Care is an important legal document. This document gives the person you name as your Health Care Agent broad powers to make health care decisions for you, including withdrawal of a feeding tube and artificial hydration. It revokes any prior power of attorney for health care that you may have made.
Because "health care" means any treatment, service, or procedures to maintain, diagnose, or treat your physical or mental condition, your Agent has the power to make a broad range of health care decisions for you.
Please note that neither your health care Agent nor your alternate health care Agent can be your health care provider or employee of a health care facility where you are a patient, or a spouse of any of those persons, unless she or he is also your relative.
Your health care Agent may not admit or commit you on an inpatient basis to an institution for mental diseases, an intermediate care facility for the mentally retarded, a state treatment facility or a treatment facility. Your health care Agent may not consent to experimental mental health research or psychosurgery, electroconvulsive treatment or drastic mental health treatment procedures for you.
Your Agent shall have the same access to your medical records that you have, including the right to disclose the contents to others, to request, receive and review verbal and written information regarding your personal affairs or physical or mental health including medical and hospital records.
There is an anatomical gift provision in this Power of attorney where you can address the disposition of your remains.
Your Agent's authority begins when your doctor certifies that you lack the competence to make health care decisions.
You should take some time to discuss your thoughts and beliefs about medical treatment with the person or persons whom you have specified.
The person you appoint as a Health Care Agent should be someone you know and trust.
You should inform the person you appoint that you want the person to be your Health Care Agent. You should discuss this document with your Agent and your physician and give each a signed copy. You should indicate on the document itself the people and institutions who have signed copies. Your Agent is not liable for health care decisions made in good faith on your behalf.
This Wisconsin Durable Power of Attorney for Health Care may not be changed or modified. If you want to make changes in the document, you must make an entirely new one.
If you wish to change your Wisconsin durable power of attorney for health care, you may revoke this document at any time by destroying it, by directing another person to destroy it in your presence, by signing a written and dated statement or by stating that it is revoked in the presence of two witnesses. If you revoke, you should notify your Agent, your health care providers and any other person to whom you have given a copy.
If your Agent is your spouse and your marriage is annulled or you are divorced after signing this document, the document is invalid.
You may also use the Wisconsin power of attorney for health care to make or refuse to make an anatomical gift upon your death. If you use this document to make or refuse to make an anatomical gift, this document revokes any prior document of gift that you may have made. you may revoke or change any anatomical gift that you make by this power of attorney for health care by crossing out the anatomical gifts provision in this document.
You may wish to designate an alternate Agent in the event that your Agent is unwilling, unable, or ineligible to act as your Agent. Any alternate Agent you designate has the same authority to make health care decisions for you.
THIS WISCONSIN POWER OF ATTORNEY IS NOT VALID UNLESS IT IS SIGNED IN THE PRESENCE OF TWO COMPETENT ADULT WITNESSES. THE FOLLOWING PERSONS MAY NOT ACT AS ONE OF THE WITNESSES:
(1) the person designated by the Principal as your Health Care Agent;
(2) a person related to the Principal by blood or marriage;
(3) a person entitled to any part of the Principal’s estate after the Principal’s death under a will or codicil executed by the Principal or by operation of law;
(4) the Principal’s attending physician;
(5) an employee of the Principal’s attending physician;
(6) an employee of a health care facility in which the Principal is a patient if the employee is providing direct patient care to the Principal or is an officer, director, partner, or business office employee of the health care facility or of any parent organization of the health care facility; or
(7) a person who, at the time this power of attorney is executed, has a claim against any part of the Principal’s estate after his or her death.
Do not sign these documents unless you clearly understand it. It is suggested that you keep the original of these legal forms on file with your physician and family members.
If there is something you do not understand about these Wisconsin Living Will Declaration and Wisconsin Health Care Power of Attorney you should consult an attorney.
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To better understand the health care and pecuniary related issues our legal articles, frequently asked questions, facts and other law related information may be of interest to you.
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