Pennsylvania Advance Directives for Health Care

Pennsylvania Advance Directives for Health Care

By Daniel B. Evans
Copyright 1992 Daniel B. Evans. All rights reserved.

On April 16, 1992, Pennsylvania joined the states with laws recognizing “living wills” when Governor Robert P. Casey signed into law Act No. 24 of 1992, which included the “Advance Directive for Health Care Act.” This act recognizes the right of a patient to control decisions relating to his or her medical care and to execute a written direction regarding life-sustaining procedures.

Under the new law, an individual of sound mind who is 18 years of age or older (or who has graduated from high school or married) may execute a declaration governing the initiation, continuation, withholding, or withdrawal of “life-sustaining treatment.” The declaration must be signed by the declarant (or by another person at the request of the declarant if the declarant is unable to sign) and must be witnessed by two individuals over the age of 18. The declaration may include a designation of another person (a “surrogate”) to make treatment decisions for the declarant if the declarant later becomes incompetent.

The form of “living will” suggested by the statute includes specific reference to seven different types of life-sustaining procedures which may be refused:

    • Cardiac resuscitation

    • Mechanical respiration

    • Tube feeding or tube hydration

    • Blood transfusions

    • Surgery or invasive diagnostics

    • Kidney dialysis

    • Antibiotics

A declaration becomes effective when the attending physician has determined that the declarant is incompetent (is unable to make or communicate decisions) and in a terminal condition (an incurable and irreversible condition which will result in death), or is in a state of permanent unconsciousness (such as an irreversible coma). However, a declaration by a pregnant woman will not become effective unless a physician has determined that the life-sustaining treatments either (a) will not permit the live birth of the unborn child, (b) will be physically harmful to the pregnant woman, or (c) would cause pain to the pregnant woman.

A declaration can be revoked at any time and in any manner, regardless of the mental or physical condition of the declarant.

Before the new law was enacted, Pennsylvanians who were concerned about inappropriate life-sustaining treatments could execute “durable” powers of attorney that authorized a family member to make medical decisions. Although these powers of attorney should continue to be effective, it is recommended that new health care directives be executed in accordance with the new act.

Click here for a sample form of advance directive for health care.

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