Table of Contents
- Free Indiana Medical Power of Attorney Forms to Print
- What is an Indiana Medical Power of Attorney
- Who Should Have an Indiana Medical Power of Attorney?
- How to Select Your Agent(s)
- Decision Making Power of Your Agent(s)
- What to do if You Change Your Mind
- How to Complete Your Indiana Medical Power of Attorney
1. Free Indiana Medical Power of Attorney Forms to Print
Download an Indiana Medical Power of Attorney Sample
2. What is an Indiana Medical Power of Attorney?
In accordance with the Indiana Health Care Consent Act, stated in Indiana Code § 16 -36 -1, an Indiana Medical Power of Attorney is a two-part document used to clarify your health care wishes to your family, friends, and physician for situations in which you are unable to speak for yourself.
In Indiana, the first part of this document includes a Durable Power of Attorney for Health Care Form and Appointment of a Health Care Representative, with the second part comprising a Living Will Declaration or Life-Prolonging Procedures Declaration.
Specifically, the first part of your Medical Power of Attorney references your health care instructions, and/or names a health care representative to act in your place should you become incompetent or unable to communicate.
The second part deals more with life-prolonging measures. This “living will” can be either a Life-Prolonging Procedures Declaration or a Living Will Declaration. The former is used to let your loved ones know that you would like all available treatment explored in order to extend your life, while the latter states that you would rather die naturally.
Important Definitions
The following definitions are codified under Indiana Code § 16-36-1:
Durable Power of Attorney for Health Care Form and Appointment of Health Care Representative – a legal document stating your health care wishes and naming a trusted person to speak such wishes in the event that you are unable to do so yourself.
Appointor – a person over the age of 18 that executes a health care directive.
Living Will Declaration or Life-Prolonging Procedures Declaration – a legal document stating the specific types of medical treatment and procedures you would or would not like to receive in order to prolong your life. Indiana Code § 16-36-4 discusses living wills in detail.
Attorney-in-Fact or Health Care Representative – a person named by the appointor to make health care decisions for him or her when he or she can no longer do so.
Alternative Document Names
The two-part document used in Indiana does not really have a different name, though it may be confused with other, similar documents that also state one’s wishes once he or she has reached a point in which he or she can no longer communicate — such as:
- Out of Hospital Do Not Resuscitate Declaration Order
- Physician Orders for Scope of Treatment (POST)
Found in Indiana Code § 16-36-5, the Out of Hospital Do Not Resuscitate Declaration Order is a document that states a person’s wishes in the event that he or she is in a condition in which cardiac and/or pulmonary failure is likely, and he or she is outside of an acute care hospital or health care facility.
A POST, found at Indiana Code § 16-36-6, is a direct physician order. It is used in the event of a medical condition from which recovery is unlikely, or in the course of any progressive illness or physical deterioration.
Who Should Have an Indiana Medical Power of Attorney?
As long as you are over the age of 18 and completely competent, you should consider completing an Indiana Medical Power of Attorney. Doing so ensures that your health care wishes are known, and a trustworthy advocate can execute them on your behalf.
How to Select Your Agent(s)
Who to Select as an Agent
Indiana law does not specifically limit the legal requirements for health care representatives except by requiring the person to be at least 18 years of age.
Additionally, Indiana Code § 16-36-1-2 provides a broad definition for what qualifies as a representative, meaning all of the following may legally be appointed as a health care representative in your medical power of attorney form:
- A corporation
- A trust or business trust
- A limited liability company
- A partnership
- An estate
- An association
- A joint venture
- A government or political subdivision
- An agency
- An instrumentality
- Any other legal or commercial entity
Who Can’t Be Your Agent
Pursuant to Indiana Code 16-36-1-9.5, the following individuals are not allowed to make medical decisions for you:
- A legally-separated spouse or current spouse officially seeking divorce, separation, or annulment.
- A person subject to a protective order or other court-appointed restraining order.
- Any person pending criminal charges in which the appointer is the alleged victim.
Can You Have More Than One Agent?
You cannot have multiple agents working in conjunction with one another in Indiana, but you may appoint a successor agent in case the primary agent does not work out. Specifically, if the first appointed agent is unable, unavailable, or unwilling to act, the successor agent can step in and take his or her place.
Decision Making Power of Your Agent(s)
What Health Care Decisions are Your Agent(s) Able Make on Your Behalf?
In accordance with Indiana Code § 16-36-1-7, your Indiana Health Care Power of Attorney allows you to provide instructions with regard to your health care decisions, and appoints a health care representative to see them through.
Your health care representative has the ability to:
- Sign contracts on your behalf
- Peruse your medical records
- Release your medical records to others
- Release or admit you to health care facilities
- Consent to or refuse your various medical treatments and procedures
As part of the Living Will Declaration, your health care representative will also see that your wishes, with regard to life-prolonging interventions, are carried out.
What Health Care Decisions are Your Agent(s) Unable to Make on Your Behalf?
While Indiana law has few limitations on a health care representative’s decision-making power, the state does not, however, authorize euthanasia, and it restricts the withholding and withdrawal of life-prolonging procedures for pregnant patients.
When is Your Agent Able to Begin Making Decisions on Your Behalf?
Executing an Indiana Medical Power of Attorney will not restrict your ability to decide your current health care needs. In accordance with Indiana Code § 16-36-1-7, it only goes into effect when the appointor is no longer capable of consenting to care or treatments on his or her own.
What to do if You Change Your Mind
How Long is Your Indiana Medical Power of Attorney Effective?
An Indiana Medical Power of Attorney stays in full legal effect until it is changed or revoked, which can be done at any time — as long as you are competent.
How to Revoke an Indiana Medical Power of Attorney
The Durable Power of Attorney and Appointment of a Health Care Representative is easily revoked by telling your health care representative or physician. You can do this in writing or orally.
The second section, the Living Will Declaration or Life-Prolonging Procedures Declaration, can also be revoked orally or in writing, though any written revocation must be signed and dated.
You may also physically destroy the document or ask someone else to do so in your presence. However, the revocation of this section can only become effective once your physician is notified.
How to Complete Your Indiana Medical Power of Attorney
Indiana Code § 16-36-1-7 (b) states that your Indiana Medical Power of Attorney is legal as long as it names the following:
- Your health care representative
- The situations in which you would like him or her to act
- The powers you wish to bestow upon him or her as well as those that you do not wish to give
It must also be set in writing and signed by you or someone who you direct to sign for you while in your presence.
Do You Need a Witness / Notary Public Signatures?
Two adults, over the age of 18, must sign your directive. Each person must state that he or she knows you and can attest that you are of sound mind.
If your Indiana Medical Power of Attorney states that you wish to have life-prolonging procedures withdrawn and/or withheld, the witnesses may not be:
- Your spouse, child, parent, or heir
- Anyone signing the declaration on your behalf
- Anyone responsible for your medical bills
What to do with Your Signed Indiana Health Care Power of Attorney
After executing your Indiana Health Care Power of Attorney, you should immediately provide your physician with a copy so he or she can file it with your medical records. You should also provide copies to your family and close friends, or let them know where a copy can be found.
