Living Wills

Pennsylvania's Advanced Directives for Healthcare Act sets forth the right of an individual over the age of 18 or who has graduated high school to execute an advanced declaration governing the initiation, continuation, withholding or withdrawal of life sustaining treatment. The declaration must be signed by the declarant and witnessed by two individuals over 18 years of age. The declaration may, but need not, follow the statutory form.

The declarant's physician is obligated under the statute to make the declaration a part of the declarant's medical record. If the physician cannot in good conscience include the form because of the physician's personal beliefs, the physician must make it known to the declarant that the physician will not comply with the request.

The declaration becomes operative when a copy is provided to the attending physician and the declarant is determined by the attending physician to be incompetent and in a terminal condition or in a state of permanent unconsciousness.

A terminal condition is defined as an incurable and irreversible medical condition in an advanced state caused by injury, disease or physical illness which will, in the opinion of the attending physician, to a reasonable degree of medical certainty, result in death regardless of the continued application of life sustaining treatment.

A person is permanently unconscious if he or she has been diagnosed "in accordance with currently accepted medical standards and with reasonable medical certainty as having a total and irreversible loss of consciousness and capacity for interaction with the environment."

Once the declaration becomes operative the medical provider must either comply with its directives or make every reasonable effort for the transfer of the patient to another provider who will comply. The declaration may be revoked at any time.

It generally makes sense for an individual to address all authorized healthcare issues in a single document, rather than use a power of attorney and a living will. Therefore, these two documents can be combined into a single "medical power of attorney".