Power of Attorney and Health Care – General – Iowa

An “attorney in fact” is an individual who is designated by a durable power of attorney for health care as an agent to make health care decisions on behalf of a principal and has consented to act in that capacity.

A “durable power of attorney for health care” is a document authorizing an attorney in fact to make health care decisions for the principal if the principal is unable, in the judgment of the attending physician, to make health care decisions.

“Health care” is any care, treatment, service, or procedure to maintain, diagnose, or treat an individual’s physical or mental condition. “Health care” does not include the provision of nutrition or hydration except when they are required to be provided parenterally or through intubation.

A “health care decision” is the consent, refusal of consent, or withdrawal of consent to health care.

A “health care provider” is a person who is licensed, certified, or otherwise authorized or permitted by the law of this state to administer health care in the ordinary course of business or in the practice of a profession.

The “principal” is a person age eighteen or older who has executed a durable power of attorney for health care.

A durable power of attorney for health care authorizes an attorney in fact to make health care decisions for the principal if the durable power of attorney for health care substantially complies with statutory requirements.

An attorney in fact can make health care decisions only if the following requirements are satisfied:

The durable power of attorney for health care explicitly authorizes the attorney in fact to make health care decisions.

The durable power of attorney for health care contains the date of its execution and is witnessed or acknowledged by one of the following methods:

Is signed by at least two individuals who, in the presence of each other and the principal, witnessed the signing of the instrument by the principal or by another person acting on behalf of the principal at the principal’s direction.

Is acknowledged before a notarial officer within this state.

The following may not be witnesses for a durable power of attorney for health care:

A health care provider attending the principal on the date of execution.

An employee of a health care provider attending the principal on the date of execution.

The individual designated in the durable power of attorney for health care as the attorney in fact.

An individual who is less than eighteen years of age.

At least one of the witnesses for a durable power of attorney for health care must be an individual who is not a relative of the principal by blood, marriage, or adoption within the third degree of consanguinity.

A durable power of attorney for health care is deemed valid and enforceable to the extent the document is consistent with the laws of Iowa. A durable power of attorney or similar document executed by a veteran of the armed forces which is in compliance with the federal department of veterans affairs advance directive requirements shall be deemed valid and enforceable.

The following individuals may not be designated as the attorney in fact to make health care decisions under a durable power of attorney for health care:

A health care provider attending the principal on the date of execution.

An employee of a health care provider attending the principal on the date of execution unless the individual to be designated is related to the principal by blood, marriage, or adoption within the third degree of consanguinity.

The statutory form is not required.

Unless a court specifically finds that the attorney in fact is acting in a manner contrary to the wishes of the principal or the durable power of attorney for health care provides otherwise, an attorney in fact who is known to the health care provider to be available and willing to make health care decisions has priority over any other person, including a guardian appointed pursuant to chapter 633, to act for the principal in all matters of health care decisions. The attorney in fact has authority to make a particular health care decision only if the principal is unable, in the judgment of the attending physician, to make the health care decision. If the principal objects to a decision to withhold or withdraw health care, the principal shall be presumed to be able to make a decision.

The attorney in fact has a duty to act in accordance with the desires of the principal as expressed in the durable power of attorney for health care or otherwise made known to the attorney in fact at any time.

A declaration executed by the principal pursuant to the life- sustaining procedures Act, chapter 144A, shall not be interpreted as expressing an intent to prohibit the withdrawal of hydration or nutrition when required to be provided parenterally or through intubation and shall not otherwise restrict the authority of the attorney in fact unless either the declaration or the durable power of attorney for health care expressly provides otherwise. If the principal’s desires are unknown, the attorney in fact has a duty to act in the best interests of the principal, taking into account the principal’s overall medical condition and prognosis.

Except as limited by the durable power of attorney for health care, an attorney in fact has the same right as the principal to receive and review medical records of the principal, and to consent to the disclosure of medical records of the principal when acting pursuant to the durable power of attorney for health care.

A durable power of attorney for health care may be revoked at any time and in any manner by which the principal is able to communicate the intent to revoke, without regard to mental or physical condition. Revocation may be by notifying the attorney in fact orally or in writing. Revocation may also be made by notifying a health care provider orally or in writing while that provider is engaged in providing health care to the principal.

A revocation is only effective as to a health care provider upon its communication to the provider by the principal or by another to whom the principal has communicated revocation. The health care provider must document the revocation in the treatment records of the principal.

A principal is presumed to have the capacity to revoke a durable power of attorney for health care.

A valid durable power of attorney for health care revokes any prior durable power of attorney for health care.

If authority granted by a durable power of attorney for health care is revoked, an individual is not subject to criminal prosecution or civil liability for acting in good faith reliance upon the durable power of attorney for health care unless the individual has actual knowledge of the revocation.

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