North Carolina Statutory Form Health Care Power Of Attorney Page 8
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11care decisions for which the principal is unable to give “informed consent.” The principal is
notified that the health care agent is not obligated to exercise the powers granted by the health
care power of attorney, but that when a power is exercised, the health care agent is duty-
bound to use due care to act in the best interests of the principal. The Notice provisions also
advise that since the powers conveyed by the health care power of attorney are “broad and
sweeping, the principal should discuss his or her wishes concerning life-sustaining
procedures, mental health treatment, and other health care decisions with his or her health
care agent.
3. Explain the contents of Section 1 (“Designation of health care agent”) in “Exhibit C:
Health Care Power of Attorney.”
Answer: Exhibit C, Section 1 specifies the individual the principal has chosen to act as his or
her health care agent. The principal is required to indicate the name, home address, home
telephone number, and work telephone number of the health care agent. Further, the
principal may (but is not required) to list the name and contact information for one (1) or
more “alternate” health care agents, in the event that the primary health care agent selected is
not reasonably available or is unwilling to act as the principal’s health care agent.
4. Explain the contents of Section 2 (“Effectiveness of appointment”) in “Exhibit C:
Health Care Power of Attorney.”
Answer: Exhibit C, Section 2 first reserves the right for the principal to revoke the health care
power of attorney “at any time (and) in any manner” by which the principal is able to
communicate his or her intent to revoke to the health care agent and the principal’s attending
physician. Section 2 also indicates the physician(s) who is/are empowered to determine that
the principal lacks sufficient capacity to make or communicate health care decisions. The
principal’s incapacity will serve to empower the health care agent to make decisions related to
the health care power of attorney.
5. Explain the contents of Section 3 (“General statement of authority granted”) in “Exhibit
C: Health Care Power of Attorney.”
Answer: Exhibit C, Section 3 lists specific powers conveyed to the health care agent by way of
the health care power of attorney. These powers include (but are not limited to) the rights:
A. To request, review, and receive any information, verbal or written, regarding the
principal’s physical or mental health, including, but not limited to, medical and hospital
records, and to consent to the disclosure of this information;
B. To employ or discharge the principal’s health care providers;
C. To consent to and authorize the principal’s admission to and discharge from a hospital,
nursing or convalescent home, or other institution;
D. To consent to and authorize the principal’s admission to and retention in a facility for the
care or treatment of mental illness;
E. To consent to and authorize the administration of medications for mental health
treatment and electroconvulsive treatment (ECT) commonly referred to as "shock treatment”;
8
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal