durable power of attorney (DPoA)
Introduction
The durable power of attorney names a health care proxy who has the power to consent to the initiation or discontinuation of any type of treatment, including life-support measures, antibiotics, nutritional support & hydration. Generally, it does not include consent for psychosurgery, sterilization or involuntary psychiatric admission. The durable power of attorney has the power to make decisions for the patient without regard to the patients previously expressed wishes. A durable power of attorney may overrule a living will.
The physician must treat preferences in care expressed by the health care proxy as the patient's own wishes. The exception is the case where the physician believes that the agent has a conflict of interest & is NOT acting with the patient's best interest in mind. Under these circumstances, proxy preferences may be disregarded.
Establishing a durable power of attorney is appropriate when a patient has decision-making-capacity. It is not appropriate if against a patient's wishes, even if physician determines the patient lacks decision-making-capacity. In theses cases, application for conservatorship is appropriate*.[3]
* ethical principles of nonmaleficence & beneficence may supersede the principle of autonomy.
More specific terms
Additional terms
References
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 583
- ↑ 3.0 3.1 Widera E, Steenpass V, Marson D, Sudore R. Finances in the older patient with cognitive impairment: "He didn't want me to take over". JAMA. 2011 Feb 16;305(7):698-706. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21325186 PMCID: PMC3799787 Free PMC article. Review.
- ↑ Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022