According to Wisconsin Statutes, any competent adult may prepare a written Directive to control the health care treatment decisions that can be made on that person behalf
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Wisconsin power of attorney for health care (medical power of attorney) gives the person you name as your agent the authority to make any and all health care decisions for you in accordance with your wishes |
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You have the right to make decisions about your health care. No health care may be given to you over your objection, and necessary health care may not be stopped or withheld if you object.
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 this Wisconsin Power of Attorney for Health Care unless you clearly understand it. It is suggested that you keep the original of this document on file with your physician. |
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