Your Iowa Advance Directive
Advance Directives protects your right to refuse medical treatment you do not want, or to request treatment you do want, in the event you lose the ability to make decisions yourself.
The Iowa Durable Power of Attorney for Health Care lets you name someone to make decisions about your medical care - including decisions about life-sustaining procedures - if you can no longer speak for yourself. The Durable Power of Attorney for Health Care is especially useful because it appoints someone to speak for you any time you are unable to make your own medical decisions, not only at the end of life. The person you choose is called your "agent." You may also hear the term "attorney-in-fact."
Your Iowa Durable Power of Attorney goes into effect when your doctor determines that you are no longer able to make or communicate your health-care decisions.
You may also appoint a designee to make choices regarding the final disposition of your remains.
The Iowa Declaration is your state's living will. It lets you state your wish to have life-sustaining procedures withheld or withdrawn in the event that you develop a terminal condition and can no longer make your own medical decisions. Your Iowa Declaration goes into effect when your doctor determines that you have a terminal condition and can no longer make your own health-care decisions or that you are permanently unconscious.
Note: These documents will be legally binding only if the person completing them is a competent adult (at least 18 years old)
Completing Your Iowa Advance Directive Form
How do I make my Iowa Advance Directive legal?
The law requires that you sign and date your advance directive. You must also have it witnessed in one of two ways:
1. Have your signature witnessed by a notary public, OR
2. Sign your document, or direct another to sign it, in the presence of two witnesses.
These witnesses cannot be:
• Your doctor or other treating health-care provider,
• An employee of your treating health-care provider,
• The person you appointed as your agent, or
• An individual who is less than 18 years of age.
At least one of your witnesses must be a person who is not related to you by blood, marriage, or adoption within the third degree of consanguinity. This means that your agent must be more distantly related to you by blood or adoption than your uncles, aunts, nephews, nieces, great-grandparents, and great-grandchildren or by marriage than your step uncles, step aunts, step nephews, step nieces, step great grandparents, and step great-grandchildren.
Whom should I appoint as my agent?
Your agent is the person you appoint to make decisions about your medical care if you become unable to make those decisions yourself. Your agent may be a family member or a close friend whom you trust to make serious decisions. The person you name as your agent should clearly understand your wishes and be willing to accept the responsibility of making medical decisions for you.
The person you appoint as your agent cannot be:
• Your doctor or other treating health-care provider, or
• An employee of your treating health-care provider, unless he or she is related to you by blood, marriage, or adoption within the third degree of consanguinity.
You can appoint a second person as your alternate agent. The alternate will step in if the first person you name as an agent is unable, unwilling, or unavailable to act for you.
Should I add personal instructions to my Iowa Advance Directive?
One of the strongest reasons for naming an agent is to have someone who can respond flexibly as your medical situation changes and deal with situations that you did not foresee. If you add instructions to this document it may help your agents carry out your wishes, but be careful that you do not unintentionally restrict your agent's power to act in your best interest. In any event, be sure to talk with your agent about your future medical care and describe what you consider to be an acceptable "quality of life."
What about Do Not Resuscitate (DNR) orders? Even if you have a living will and/or Durable Healthcare Power of Attorney, it is important to talk with your family and your Provider about your desires regarding resuscitation.
What if I change my mind?
You may revoke your Durable Power of Attorney for Health Care or Declaration at any time and in any manner, regardless of your mental or physical condition. Your revocation becomes effective when you, or someone else, communicate this revocation to your attending physician. If you appoint your spouse as your agent and your marriage ends, your agent's power is automatically revoked. If you decide to declare a designee to make choices regarding the final disposition of your remains, you may only revoke that power in a signed writing.
Advance Directives are not required in order to be provided care and you cannot be discriminated against as an individual based on whether or not you have an advance directive in place. If you have a complaint regarding lack of compliance with advance directives, you should contact:
Iowa Department of Inspections and Appeals
Lucas State Office Building
321 East 12th Street
Des Moines, Iowa 50319- 0083
(515) 281- 7102