- Do I need both a living will and a health care power of attorney?
- Yes. They cover different situations. Under Pennsylvania's Act 169 of 2006, a living will operates only when your attending physician has determined you have an end-stage medical condition or are permanently unconscious, and it speaks only to life-sustaining treatment. A health care power of attorney appoints an agent who can make any medical decision — surgery, placement, medication, discharge — in any circumstance where you cannot decide for yourself. Most clients sign a combined advance health care directive containing both.
- When does a Pennsylvania living will take effect?
- Only after two conditions are met: a copy is given to your attending physician, and that physician determines you are incompetent and have either an end-stage medical condition or are permanently unconscious. Until then it has no operative effect, and you continue making your own decisions no matter what the document says. If you are conscious and able to communicate, your contemporaneous instructions always override the written directive.
- Can my family override my health care wishes?
- Not lawfully. A validly executed Pennsylvania advance directive binds providers, and your named health care agent's authority displaces other relatives. In practice, hospitals hesitate when a family member objects loudly at the bedside, which is why we recommend naming a single decisive agent rather than co-agents, giving copies to your physician and agent in advance, and telling your family what you chose before there is a crisis. Under Act 169 a provider who objects on conscience grounds must transfer your care rather than simply ignore the directive.
- What happens if I have no health care directive in Pennsylvania?
- Act 169 supplies a default 'health care representative' in priority order — spouse and adult children, then adult child, parent, adult sibling, adult grandchild, then a close friend. That representative can make most decisions, but the list can produce deadlock among equally ranked relatives, and withholding life-sustaining treatment in a contested situation may end up in Orphans' Court. Naming your own agent removes the ambiguity.
- Why do I also need a HIPAA authorization?
- Because decision-making authority and information access are separate under federal law. A stand-alone HIPAA release lets your agent — and any other family member you list — obtain records and speak with physicians immediately, without waiting for a determination that you are incapacitated. Without it, providers routinely refuse to share information even with a spouse, which stalls everything from a second opinion to a discharge plan.