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Advance Directives in Pennsylvania

Pennsylvania’s Advance Directive for Health Care Act declares that all competent adults have a qualified right to control the decisions that relate to their own medical care. To promote and give effect to this right, the law allows any person of sound mind who is 18 years of age (or who has graduated from high school or has married) to complete a declaration governing the initiation, continuation, withholding, or withdraw of life sustaining treatments. Such a declaration is a written document through which a person specifies those medical procedures or interventions that he or she does or does not wish to have in the event the person is later terminally ill or in a state of permanent unconsciousness and where such procedure or intervention would serve only to prolong the process of dying or maintain the person in the state of permanent unconsciousness.

How to Complete a Declaration

    If you wish to complete a declaration concerning the use of life sustaining treatment, you must sign it or direct that another person sign it on your behalf. In either case, the signature must be witnessed by two persons each of whom is at least 18 years of age. If you have another person sign on your behalf, that person may not also act as a witness.

Suggested Form

    The Advance Directive for Health Care Act contains a suggested form, or other form that you prefer, to state your specific directions as you see fit. You may use the suggested form, or other form that you prefer, to state your specific instructions concerning what you do or do not want in the way of life sustaining treatment; and you may designate in your declaration another person to make medical treatment decisions on your behalf if you later lose the ability to make them on your own and if you are later determined to be in a terminal condition or to be permanently unconscious.

After You Complete a Declaration

    If you complete a declaration relaying to the use of life sustaining treatment, you should provide a copy to your physician or other health care provider who will make it a part of your medical record. A declaration becomes operative when a copy is provided to the person’s attending physician and when the person is determined by the attending physician to be incompetent and either in a terminal condition or a state of permanent unconsciousness.

If You Wish to Revoke Your Declaration

    If you complete a declaration and later change your mind, you may revoke it at any time and in any manner, without regard to your mental or physical condition at the time you wish to revoke. Methods of revocation would include, for example, physically destroying the document, signing a written statement expressing your wish to revoke, or making an oral declaration of your intention to revoke. Whatever method a person chooses, his or her revocation becomes effective once it is communicated to the attending physician or other healthcare provider by the person or by a witness to the act of revocation.

Safeguards

    The Advance Directive for Health Care Act includes a number of safeguards in connection with a person’s exercise of his or her right to make medical treatment decisions through advance directives. These include, for example:

    If a person has made no declaration, that fact by itself gives rise to no presumptions one way or another as to the intent of the person to consent to or refuse to consent to the initiation, continuation, or termination of life sustaining treatment.

    Since a declaration becomes operative only when there is a determination that the person lacks the capacity to make his or her own decisions and is also in a terminal condition or a state of permanent unconsciousness, the person retains the right to make his or her own decisions directly, without regard to an advance directive, until such time as a determination of incompetence is made by the attending physician in accordance with the Advance Directive for Health Care Act.

    If an attending physician or their healthcare provider cannot comply with a person’s declaration, or if the policies of such health care provider stand in the way of compliance, such attending physician or health care provider must so inform the declarant, or if the declarant is incompetent, the person’s surrogate decision maker, or if none has been named, the family, guardian, or other representative of the person. The physician or health care provider must then make every reasonable effort to assist in the transfer of the person to another physician or health care provider who will comply with the declaration as made by the person.

    Completing a declaration regarding life sustaining treatment is entirely voluntary, and physicians, other healthcare providers, and providers of health insurance benefits, are precluded from requiring any person to complete a declaration as a condition for being insured or receiving health care services, and they may not discriminate in the rates or fees they charge based on whether a person does or does not have an advance directive.

     Copyright 1992, 1995 CAREsource Program Development, Inc. This information summarizes important highlights of advance directive options available in Pennsylvania. It is not intended to be used in place of legal advice. Read any advance directive form carefully before you sign it. If you have any questions concerning your particular circumstances or feel you need more information concerning your options, consult an attorney or other qualified advisor.