Power of Attorney and Health Care – General – District of Columbia

An “attorney in fact” is the person who receives power of attorney for health-care decisions pursuant to the provisions of Title 21, Chapter 22.

A “durable power of attorney for health care” is a legally enforceable document that:

Is executed in the District in a manner consistent with this chapter or validly executed in another jurisdiction pursuant to similar provisions of the law of that jurisdiction; and

Creates a power of attorney for health-care decisions, which is effective upon, and only during incapacitation and is unaffected by the subsequent disability or incapacity of the principal.

An “incapacitated individual” is an adult individual who lacks sufficient mental capacity to appreciate the nature and implications of a health-care decision, make a choice regarding the alternatives presented or communicate that choice in an unambiguous manner.

A “principal” means a person who is competent to make health-care decisions for his or her own benefit or on his or her own account.

An individual is presumed capable of making health-care decisions unless certified otherwise under § 21-2204. Mental incapacity to make a health-care decision is be inferred from the fact that an individual:

Has been voluntarily or involuntarily hospitalized for mental illness pursuant to § 21-501 et seq.;

Is mentally retarded or has been determined by a court to be incompetent to refuse commitment under § 6-1901 et seq.; or

Has a conservator or guardian appointed pursuant to § 21-1501 et seq. or § 21-2001 et seq.

Mental incapacity to make a health-care decision must be certified by two physicians who are licensed to practice in the District and are qualified to make a determination of mental incapacity. One of the two certifying physicians shall be a psychiatrist. Both certifying physicians shall give an opinion regarding the cause and nature of the mental incapacity as well as its extent and probable duration.

A competent adult may designate, in writing, an individual who shall be empowered to make health-care decisions on behalf of the competent adult if the competent adult becomes incapable, by reason of mental disability, of making or communicating a choice regarding a particular health-care decision.

A durable power of attorney for health care must include language which clearly communicates that the principal intends the attorney in fact to have the authority to make health-care decisions on behalf of the principal and must include language identical or substantially similar to the following:

“This power of attorney shall not be affected by the subsequent incapacity of the principal.”; or

“This power of attorney becomes effective upon the incapacity of the principal.”

A durable power of attorney for health care shall be dated and signed by the principal and two adult witnesses who affirm that the principal was of sound mind and free from duress at the time of signing. The two adult witnesses cannot include the principal, the health-care provider of the principal or an employee of the health-care provider of the principal.

Of the 2 adult witnesses, at least one cannot be related to the principal by blood, marriage or adoption and shall not be entitled to any part of the estate of the principal by a current will or operation of law.

Any written form meeting the requirements of § 21-2205 may be used to create a durable power of attorney for health care. The statutory form is a sample only and does not preclude the use of alternative language.

At any time that the principal has the capacity to create a durable power of attorney for health care, the principal may revoke the appointment of the attorney in fact under a durable power of attorney for health care by notifying the attorney in fact orally or in writing or revoke the authority to make health-care decisions granted to the attorney in fact under a durable power of attorney for health care by notifying the health-care provider orally or in writing.

If a health-care provider is notified of a revocation, the health-care provider shall document this fact in the patient-care records of the principal and make a reasonable effort to notify the attorney in fact of the revocation.

There is a rebuttable presumption that a principal has the capacity to revoke a durable power of attorney for health care.

Unless it expressly provides otherwise, a valid durable power of attorney for health care revokes any prior durable power of attorney for health-care decisions only.

Unless a durable power of attorney for health care expressly provides otherwise, and after its execution the marriage of the principal is dissolved or annulled, the dissolution or annulment shall automatically revoke a designation of the former spouse as an attorney in fact to make health-care decisions for the principal. If a designation is revoked solely on account of this subsection, it shall be revived by the remarriage of the principal to the former spouse but may be subsequently revoked by an act of the principal.

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