Hebrew source: רישום הנחיות רפואיות מקדימות
From All Rights (Kol-Zchut) (www.kolzchut.org.il)
An individual is permitted to prepare a living will in preparation for the possibility of being considered terminally ill
The instructions are valid for five years, though they may be extended
In addition, that individual may appoint someone to have power of attorney to give instructions in his/her place
In cases where a living will was given and a power of attorney was appointed, in general, preference will be given to the living will
For more information, see the Ministry of Health's English website
- They are also entitled to appoint someone to have power of attorney who will be authorized to make decisions in their stead in such a situation.
- It is possible to combine a living will with the appointment of a power of attorney.
- In this case, it is recommended to provide clear instructions regarding the possibility of a contradiction between the living will and instruction from the person with power of attorney.
- As a general rule, if there are no such instructions, and there is a contradiction, preference will be given to what is written in the living will.
- In cases where power of attorney was given a significant amount of time after the living will, an institutional committee will determine if the power of attorney takes precedence over the living will or not.
Target Audience and Prerequisites
Someone is considered to be competent to make decisions regarding his/her medical care if all of the following three conditions are met:
- He/she is at least 17 years old.
- He/she has not been declared to be legally incompetent.
- He/she is capable of expressing his/her will.
Stages of the Process
- Firstly, individuals must consider the issue carefully before coming to a decision regarding their will with regard to the medical care they will receive in the event that they are determined to be "terminally ill".
- It is recommended to talk with family members to ensure that they are aware of these wishes.
- A Living Will Form should then be filled out carefully, and after receiving explanations from a doctor or nurse.
- Those who are already considered to be terminally ill when filling out the form must receive explanations from a medical specialist who is familiar with their medical condition and can clarify the significance of receiving or not receiving a particular type of treatment (i.e. in relation to it causing pain or suffering; preventing pain or suffering; impacting life expectancy, etc.).
- The form must be signed before two witnesses who have no economic or other interests, and who have not been given power of attorney. The witnesses must sign the form in order to confirm the grantor's signature.
Expiration and Extension of a Living Will
- Living wills are valid for five years from the date the form was signed, unless a shorter period of validity was established.
- The validity of living wills may be extended for up to five years at a time.
- Extension of a living will may be performed by filling out a Living Will Extension Form.
Change and Cancellation of a Living Will
- When an individual submits a living will, this invalidates any and all prior living wills that person may have had.
- A living will may be canceled in writing before two witnesses, by filling out a Living Will Cancellation Form.
- Living wills that are not renewed after five years do not become completely invalid; but rather, they become non-obligatory.
- A doctor may use an old living will that has expired to form an opinion regarding the patient's will if it must be ascertained and the patient is unable to express it. Accordingly, those who would like to cancel a living will make sure that it is clear that they have completely changed their mind should fill out a Living Will Cancellation Form.
Patients Unable to Sign
- Submitting a living will, granting power of attorney, as well as all changes and cancellations require the grantor to be able to sign in his/her own name.
- Patients unable to sign their own name due to illness or disability are permitted to put a finger print in the area designated for a signature.
- If someone requires the assistance of someone else to sign or put a finger print, the signature or finger print is invalid.
- In such a case, the grantor may make a verbal declaration before two witnesses:
- The grantor must declare verbally that he/she was prevented from signing the form due to physical limitations and that everything written on the form is in accordance with his/her personal opinion and consent as the result of careful consideration and free will, and not as the result of familial, societal or any other form of pressure.
- The declaration must be documented in writing and the witnesses must sign, indicating their verification regarding everything that was stated in the declaration.
Storing Documents in a Database
- Grantors may store relevant documents anywhere they see fit.
- The Ministry of Health also recommends that the documents be stored in the Ministry of Health's Center for Preparatory Medical Guidance's database.
- The forms must be mailed by registered mail to the following address, with a photocopy of the individual’s ID card (teudat zehut):
- The Ministry of Health
- The Center for Preparatory Medical Guidance
- P.O. Box 1176
- Jerusalem 9101002
- In urgent situations the following contact details may be used:
- Phone: 02-670-6825
- Fax: 02-670-6922
- Email: email@example.com
- The following will be performed at the center:
- The forms will be thoroughly examined to make sure they have been filled out clearly and correctly in order to avoid any lack of clarity at the time they are needed.
- The documents will be stored and kept available for those treating a terminally ill patient, if needed.
- Before expiring, the grantor will receive a reminder (to the address indicated on the request) to renew the forms.
- Physicians treating a terminally ill patient may check with the database if the patient has submitted a living will or power of attorney, and may receive a copy of the relevant documentation if needed.
- Before signing, doctors sometimes require that one of the witnesses signing the form be a lawyer. It is important to clarify that the law does not require one of the people signing the form to be a lawyer. All that is required is that neither of them have power of attorney for the grantor, nor economic or other interests related to the grantor.
- If the parties would like a lawyer to sign the form, it is important to know that there are lawyers who do not charge for such a signature or who charge a symbolic fee, because they are simply signing on a prepared form and no writing or editing is required on their part.
- Another option in determining how and by whom a persons medical care will be decided if he can not care for himself is through the preparation of | Continuing Power of Attorney
- The Terminally Ill Patient Law at The Ministry of Health website.
- Explanatory sheets for filling the forms with the first and second addendum - Living wills and power of attorney.