A new act changes Pennsylvania’s law on health care directives and living wills (also known as “advance directives”) in some important ways.

For years, Pennsylvania law has authorized adults to make health care directives to state what measures may or may not be taken to prolong the life of someone in a terminal condition, persistent vegetative state, or who was permanently unconscious with no realistic hope of significant recovery (“living will”), and to appoint an agent to make health care decisions.

Here are some of the highlights of the new law, effective January 29, 2007, which was enacted as Pennsylvania Act 169:

  • For the first time in Pennsylvania, there is a statutory list of persons designated to make decisions for someone who has no agent or “surrogate” under a health care power of attorney, or whose agent is not available or not willing to act. In such a circumstance, decisions may be made by a “health care representative.”The act sets forth the following priority for persons who may act as a health care representative: the spouse (unless a divorce action has been filed) and adult children from a prior marriage; an adult child; a parent; an adult sibling; an adult grandchild; and an adult who is familiar with the patient’s preferences and values and who exhibits special care and concern for the patient.
  • The act makes some important changes in terminology. For example, the new law shifts away from use of the phrase “terminal condition” in favor of the term “end-stage medical condition.” Use of the new term helps to clarify that patients at the end of life may receive treatment of a disease or other condition if it is of some benefit (as in the case of palliative care) and does not merely prolong the process of dying.
  • The new law contains expanded detail on who may make a health care power of attorney, and what optional provisions the document may (but need not) contain. Health care providers may not serve as a health care agent unless related to the patient by blood, marriage, or adoption.
  • Under the new law, health care directives that have already been signed remain valid. But the law contains new “suggested” (not mandatory) forms based on this revision of state law.
  • Many other small but important changes to the way end-stage health care decisions may be made and communicated in Pennsylvania. Those who work in that area, or who have an interest in the subject, would benefit from reading the new law.

Those who do not have health care directives should make one, to state their wishes clearly and appoint agents to act on their behalf, and discuss these issues with those whom they appoint.

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