202005711 - Laserfiche WebLink

Browse

202005711 (7) Power to Maintain Me in My Residence. My Agent is authorized to take whatever steps are necessary or advisable to enable me to remain in my personal residence as long as it is reasonable under the circumstances to maintain me in my residence. (8) Power to Exercise My Health Care Right of Privacy. My Agent is authorized to exercise all state and federal rights that I may have, including but not limited to my right of privacy to make decisions regarding my health care. (9) Power to Authorize Relief from Pain. My Agent is authorized to consent to the administration of pain -relieving drugs of any kind, or other surgical or health care procedures calculated to relieve my pain, even though such drugs or procedures may lead to permanent physical damage, addiction, or even hasten the moment of, but not intentionally cause, my death. (10) Power to Grant Releases. My Agent is authorized to grant releases to hospital staff, physicians, and other health care providers who act in reliance on instructions given by my Agent from all liability for damages suffered or to be suffered by me. ARTICLE V REFUSAL OF HEALTH CARE TREATMENT Authority for the Refusal of Health Care. I wish to live and enjoy life as long as possible. However, I do not wish to receive health care treatment that will only postpone the moment of my death from an incurable and terminal condition or prolong an irreversible coma. For purposes of this instrument, (1) "terminal condition" shall refer to a condition that is reasonably expected to result in my death within twelve (12) months regardless of the treatment I may receive, and (2) "irreversible coma" shall refer to a permanent loss of consciousness from which there is no reasonable possibility that I will return to a cognitive and sapient life and shall include but shall not be limited to that condition known as a persistent vegetative state. Therefore, if one licensed qualified physician who is familiar with my condition has diagnosed and noted in my medical records that: i) I am unable to give informed consent to health care treatment that is proposed or available for my condition and my condition is terminal, or ii) I have been in a coma for at least sixty (60) days and that the coma is irreversible as defined above, then my Agent is authorized to: i) direct that health care be withheld or, if previously begun, to direct that such treatment be withdrawn, ii) request, require, or consent to the writing of a "No -Code" or "Do Not Resuscitate" order by any of my attending physicians, iii) sign on my behalf any documents necessary to carry out the authorizations, and iv) order whatever is appropriate to keep me as comfortable and free of pain as is reasonably possible, even though such drugs or procedures may lead to permanent physical damage or addiction, or hasten the moment of, but not intentionally cause, my death. ARTICLE VI INCIDENTAL POWERS In connection with the exercise of the powers herein described, my Agent is fully authorized and empowered to perform any acts and things and to execute and deliver any documents, instruments, affidavits, certificates, and papers necessary or appropriate to such exercise or exercises. Durable Power of Attorney for Janice S. Nikodym Page 8