Power of Attorney and Health Care – General – Wisconsin

POWER OF ATTORNEY FOR HEALTH CARE

General Requirements (§155.10):

A power of attorney for health care MUST be in writing;dated and signed by the principal or by an individual who has attained age 18, at the express direction and in the presence of the principal; signed in the presence of 2 witnesses who meet the statutory requirements (see below); and be voluntarily executed.

Execution Requirements (§155.10):

Each witness to the execution of a power of attorney for health care MUST be an individual who has attained age 18.No witness may, at the time of the execution, be any of the following: Related to the principal by blood, marriage or adoption. Have knowledge that he or she is entitled to or has a claim on any portion of the principal’s estate. Directly financially responsible for the principal’s health care. An individual who is a health care provider who is serving the principal at the time of execution, an employee, other than a chaplain or a social worker, of the health care provider or an employee, other than a chaplain or a social worker, of an inpatient health care facility in which the principal is a patient. The principal’s health care agent.

Revocation Requirements (§155.40):

A principal may revoke his or her power of attorney for health care at any time by doing any of the following: Canceling, defacing, obliterating, burning, tearing or otherwise destroying the power of attorney for health care instrument or directing another in the presence of the principal to destroy the power of attorney for health care instrument; Executing a statement, signed, dated, and in writing, expressing the principal’s intent to revoke the power of attorney for health care; Verbally expressing, in the presence of two witnesses, the principal’s intent to revoke the power of attorney for health care; or Executing a subsequent power of attorney for health care instrument.

DECLARATION TO PHYSICIANS

General Information (§154.03):

Any person of sound mind and 18 years of age or older may execute a declaration authorizing the withholding or withdrawal of life sustaining procedures or of feeding tubes when the person is in a terminal condition or is in a persistent vegetative state. However, such a declaration will not be effective as to the administration of medication or tube feeding if declarant’s attending physician determines that the withdrawal of food or medicine will cause pain or reduce declarant’s comfort. A declarant may not authorize the withholding or withdrawal of nutrition or hydration (except tube feeding) unless declarant’s physician determines that the administration of same is medically contraindicated.

Execution and Witness Requirements (§154.03):

A declaration must be signed by the declarant in the presence of 2 witnesses. Another person, or one of the witnesses, can sign the declaration if the declarant is unable to sign. The signing must be in the declarant’s presence. Signing in this manner must be acknowledged or signed in the presence of two witnesses. The declarant is responsible for notifying the attending physician of the existence of the declaration. The attending physician must make the declaration a part of the declarant’s medical records. The following MAY NOT be witnesses to the execution of a declaration: A person who is related to the declarant by blood, marriage or adoption; A person who has knowledge that he or she is entitled to or has a claim on any portion of the declarant’s estate; A person who is directly financially responsible for the declarant’s health care; or A person who is a health care provider, as defined in §155.01(7) who is serving the declarant at the time of execution, an employee, other than a chaplain or a social worker, of the health care provider or an employee, other than a chaplain or a social worker, of an inpatient health care facility in which the declarant is a patient.

Mandatory Form (154.03(2)):

A Declaration to Physicians MUST be in the form provided for in the statute.

Revocation Requirements (§154.05):

A declaration may be revoked at any time by any of the following: By being canceled, defaced, obliterated, burned, torn or otherwise destroyed by the declarant or by some person who is directed by the declarant and who acts in the presence of the declarant. By a written revocation of the declarant expressing the intent to revoke, signed and dated by the declarant. By a verbal expression by the declarant of his or her intent to revoke the declaration. This revocation becomes effective only if the declarant or a person who is acting on behalf of the declarant notifies the attending physician of the revocation. By executing a subsequent declaration.

ANATOMICAL GIFTS

General Information (§157.06)

A “document of gift” means a card, a statement attached to or imprinted on a license or on an identification card, a will or another writing used to make an anatomical gift.

Making An Anatomical Gift (§157.06):

An individual who is at least 18 years of age may do any of the following: Make an anatomical gift for any of the statutorily approved purposes; Limit an anatomical gift to one or more of the statutorily approved purposes; or Refuse to make an anatomical gift. An anatomical gift may be made only by a document of gift signed by the donor. If the donor cannot sign, the document of gift shall be signed by another individual and by 2 witnesses, all of whom have signed at the direction and in the presence of the donor and of each other, and the document of gift MUST state that it has been so signed.

Revoking Or Amending An Anatomical Gift (§157.06):

A donor may amend or revoke an anatomical gift or a refusal to make an anatomical gift by doing any of the following: Signing a statement of amendment or revocation; Signing a new document of gift. Signing a new document of gift revokes any previously signed document of gift; Verbally amending or revoking in the presence of 2 individuals; During the donor’s terminal illness or injury making, by any form of communication that is addressed to a physician, an amendment or revocation; Delivering a signed statement of amendment or revocation to a specified donee to whom a document of gift had been delivered; Crossing out or amending the donor authorization or refusal in the space provided on his or her license or identification card; or Revoking the provision of a power of attorney for health care instrument that makes an anatomical gift or revoking that power of attorney for health care instrument.

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