Introduction:

Those interested in making preparations for the possibility that they will be terminally ill, may prepare a living will and/or appoint someone to have power of attorney to give instructions in their place in accordance with the Terminally Ill Patient Law
Additionally, according to the Patients' Rights Law, one can give a Power of Attorney for Medical Treatment for situations in which he is unable to make his own decisions even if the person is not classified as a terminally ill patient. .
For more information, see the Ministry of Health's English website

The Terminally Ill Patient Law allows everyone to express their will in advance regarding medical treatment if and when they are ever determined to be terminally ill, by means of a living will.

  • They are also entitled to give someone (a proxy) power of attorney who will be authorized to make decisions in their stead in such a situation.
  • The power of attorney is valid exclusively in regards to medical issues and the proxy can have one of three levels of authority:
  1. In this option the proxy is entitled to make any decision specified in the power of attorney form, about treatment or non-treatment on behalf of the grantor, (with this option the proxy is not obligated to receive and explanation from the doctor/certified nurse of the medical terms).
  2. In this option the proxy is limited to making decisions only regarding treatments that can extend life.
  3. In this option the proxy can make detailed decisions about which treatments should be avoided or permitted.

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

  • It must be verified that the proxy granted power of attorney (who must consent to the appointment) understands the grantor's wishes and consents to act according to them, and that the grantor trusts the proxy and believes that he/she will act according to these wishes.
  • It is possible to only grant power of attorney privileges for specific medical situations or treatments. In such a case, power of attorney may only be granted after the grantor and the proxy have received relevant explanations and medical information from a physician or certified nurse.
  • If the grantor is already considered to be terminally ill, relevant explanations and medical information will only be provided by a doctor specializing in the relevant field.
  • Power of attorney may be granted in writing on a Power of Attorney Form.
  • The grantor must detail the circumstances and conditions according to which the representative would be authorized to make decisions on the patient's behalf.
  • It is possible to give power of attorney to a number of people who will make decisions in conjunction with one another.
  • If more than one proxy has been granted power of attorney, all of the proxies must agree to the appointment, and they all must receive the required explanations. Additionally, the appointment documentation must include instructions regarding how decisions are to be made in the event that not everyone is present, or a unanimous decision is not reached, etc.
  • An alternative proxy may be appointed in the event that the primary proxy cannot fulfill his/her obligation or refuses to do so.
  • Proxies must sign the power of attorney form before two witness, (who must both be present for the signing).
  • The witnesses must be people who have not been given power of attorney, and who have no economic or other interests related to the instructions.
  • Doctors and nurses (included those who provided explanations or disclosed the medical information) may serve as witnesses.
  • With their signature on the power of attorney form, the witnesses verify the signature of the grantor.

Expiration of Power of Attorney

  • Power of attorney is valid for five years from the date the form was signed, unless a shorter period of validity was established.
  • Power of attorney validity may be extended for up to five years at a time.
  • Power of attorney validity may be extended by filling out a Power of Attorney Extension Form.

Change and Cancellation of Power of Attorney

  • When an individual appoints power of attorney, this invalidates any and all prior appointments.
  • Power of attorney may be canceled in writing before two witnesses, by filling out a Power of Attorney 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 Data Bank of Advance Medical Directives' 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: maagar.medida@moh.health.gov.il
  • The following will be performed at the center:
  1. 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.
  2. The documents will be stored and kept available for those treating a terminally ill patient, if needed.
  3. Before expiring, the grantor will receive a reminder (to the address indicated on the request) to renew the forms.
  4. 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.




Signature of a Lawyer

  • In certain situations the doctor may require that one of the witnesses signing the form be a lawyer
  • It is important to clarify that the law does not require the signature of a lawyer on the form and it is sufficient that the witness be anyone except the grantor himself or someone who has financial or other interests.
  • In situations when the sides want the signature of a lawyer it is important they know that because we are talking only about a signature on prepared forms, there are lawyers who will sign the forms without taking a fee or by taking a symbolic fee.

General Power of Attorney for Medical Treatment

  • The power of attorney discussed here is only relevant to situations in which the grantor is terminally ill
  • The Patients' Rights Law allows anyone who wishes to assign power of attorney to a proxy who will be authorized to make medical decisions on their behalf in the event they are unable to do so themselves and are not considered to be terminally ill.
  • Therefore one should consider giving a general power of attorney for medical treatments. For more information see Power of Attorney for Medical Treatment

Combined Power of Attorney

  • In the past it was possible for one to appoint a power of attorney for general medical treatments and for the event that he was terminally ill on the same form.
  • In light of the amendment in the Legal Competency and Guardianship Law that came into effect on 11.04.2017, one can no longer assign both of these powers of attorney on the same, combined form. They must be filled out on two separate forms.
  • Combined power of attorney forms that were signed before this date and registered on the Ministry of Health website according to the law will be honored and continue to be valid until their expiration dates (5 years from the approval date).
  • Any future changes or renewal of the current directive must be done in accordance with the Terminally Ill Patient Law (notification of this will be sent at the time of renewal).



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