One can combine a general power of attorney and a medical power of attorney regarding medical treatment for terminally ill patients,which includes a Power of Attorney for Medical Treatment.
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 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.
- Combination of living will and power of attorney:
- It is possible to combine a living will with appointing 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
- 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 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
- 39 Yirmiyahu St., Jerusalem 9446724
- Postal address: P.O. Box 1176, Jerusalem 9101002
- Additional contact details:
- Phone: *5400, 08-6241010
- Fax: 02-5655969
- 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.
- 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.
Combining a General Power of Attorney and Medical Power of Attorney for Terminally Ill Patients
- The accepted legal position is that legal documents relating to terminal illness are not valid for patients not considered to be terminally ill, and vice versa.
- The Terminally Ill Patient 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 in addition to a medical power of attorney.
- Thus one can give An integrated power of attorney for medical care terminal illness, which covers both situations.
- 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.
Laws and Ordinances
- Terminally Ill Patient Act 2005
- Instructions for filing the forms - Preliminary medical guidelines for power of attorney
- Ministry of Health Circular 8/2005 dated 4.5.2015 Combined Power of Atrorney according to the Patients' Rights Act and the Terminally Ill Patient Act.
- Explanatory sheets for filling the forms with the first and second addendum - Living wills and power of attorney
- The Ministry of Health website: The Terminally Ill Patient Law
- The Association of Law in the Service of the Elderly: B'Mabat Lifnim leaflet - Legal Planning for Seniors
- Original translation by AACI's Shira Pransky Project.