|
(a) Where a rule of law requires information to be |
"written" or
"in writing", or provides for
certain consequences |
if it is not, an electronic record satisfies that rule of
law.
|
(b) The provisions of this Section shall not apply:
|
(1) when its application would involve a construction |
of a rule of law
that
is clearly
inconsistent with the |
manifest intent of the lawmaking body or repugnant to the
|
context of the
same rule of law, provided that the mere |
requirement that information be "in
writing", "written",
|
or "printed" shall not by itself be sufficient to establish |
such intent;
|
(2) to any rule of law governing the creation or |
execution of a will or
trust, living
will, or healthcare |
power of attorney; and
|
(3) to any record that serves as a unique and |
transferable instrument of
rights and
obligations |
including, without limitation, negotiable instruments and |
other
instruments of title
wherein possession of the |
instrument is deemed to confer title, unless an
electronic |
version of
such record is created, stored, and transferred |
in a manner that allows for the
existence of only
one |
unique, identifiable, and unalterable original with the |
functional
attributes of an equivalent
physical |
instrument, that can be possessed by only one person, and |
which cannot
be copied
except in a form that is readily |
identifiable as a copy.
|
|
(Source: P.A. 90-759, eff. 7-1-99.)
|
(5 ILCS 175/5-120)
|
Sec. 5-120. Electronic signatures.
|
(a) Where a rule of law requires a signature, or provides |
for certain
consequences if a
document is not signed, an |
electronic signature satisfies that rule of law.
|
(a-5) In the course of exercising any permitting, |
licensing, or other regulatory function, a municipality may |
accept, but shall not require, documents with an electronic |
signature, including, but not limited to, the technical |
submissions of a design professional with an electronic |
signature. |
(b) An electronic signature may be proved in any manner, |
including by
showing that a
procedure existed by which a party |
must of necessity have executed a symbol or
security procedure |
for
the purpose of verifying that an electronic record is that |
of such party in
order to proceed further with a
transaction.
|
(c) The provisions of this Section shall not apply:
|
(1) when its application would involve a construction |
of a rule of law
that is clearly
inconsistent with the |
manifest intent of the lawmaking body or repugnant to the
|
context of the
same rule of law, provided that the mere |
requirement of a "signature" or that a
record be
"signed" |
shall not by itself be sufficient to establish such intent;
|
(2) to any rule of law governing the creation or |
|
execution of a will or
trust, living
will, or healthcare |
power of attorney; and
|
(3) to any record that serves as a unique and |
transferable instrument of
rights and
obligations |
including, without limitation, negotiable instruments and |
other
instruments of title
wherein possession of the |
instrument is deemed to confer title, unless an
electronic |
version of
such record is created, stored, and transferred |
in a manner that allows for the
existence of only
one |
unique, identifiable, and unalterable original with the |
functional
attributes of an equivalent
physical |
instrument, that can be possessed by only one person, and |
which cannot
be copied
except in a form that is readily |
identifiable as a copy.
|
(Source: P.A. 98-289, eff. 1-1-14.)
|
Section 10. The Department of Public Health Powers and |
Duties Law of the
Civil Administrative Code of Illinois is |
amended by changing Section 2310-600 as follows:
|
(20 ILCS 2310/2310-600)
|
Sec. 2310-600. Advance directive information.
|
(a) The Department of Public Health shall prepare and |
publish the summary of
advance directives law, as required by |
the federal Patient
Self-Determination Act, and related forms. |
Publication may be limited to the World Wide Web. The summary |
|
required under this subsection (a) must include the Department |
of Public Health Uniform POLST form.
|
(b) The Department of Public Health shall publish
Spanish |
language
versions of the following:
|
(1) The statutory Living Will Declaration form.
|
(2) The Illinois Statutory Short Form Power of Attorney |
for Health Care.
|
(3) The statutory Declaration of Mental Health |
Treatment Form.
|
(4) The summary of advance directives law in Illinois.
|
(5) The Department of Public Health Uniform POLST form.
|
Publication may be limited to the World Wide Web.
|
(b-5) In consultation with a statewide professional |
organization
representing
physicians licensed to practice |
medicine in all its branches, statewide
organizations |
representing physician assistants, advanced practice |
registered nurses, nursing homes, registered professional |
nurses, and emergency medical systems, and a statewide
|
organization
representing hospitals, the Department of Public |
Health shall develop and
publish a uniform
form for |
practitioner cardiopulmonary resuscitation (CPR) or |
life-sustaining treatment orders that may be utilized in all
|
settings. The form shall meet the published minimum |
requirements to nationally be considered a practitioner orders |
for life-sustaining treatment form, or POLST, and
may be |
referred to as the Department of Public Health Uniform POLST |
|
form. An electronic version of the Uniform POLST form under |
this Act may be created, signed, or revoked electronically |
using a generic, technology-neutral system in which each user |
is assigned a unique identifier that is securely maintained and |
in a manner that meets the regulatory requirements for a |
digital or electronic signature. Compliance with the standards |
defined in the Electronic Commerce Security Act or the |
implementing rules of the Hospital Licensing Act for medical |
record entry authentication for author validation of the |
documentation, content accuracy, and completeness meets this |
standard. This form does not replace a physician's or other |
practitioner's authority to make a do-not-resuscitate (DNR) |
order.
|
(b-10) In consultation with a statewide professional |
organization representing physicians licensed to practice |
medicine in all its branches, statewide organizations |
representing physician assistants, advanced practice |
registered nurses, nursing homes, registered professional |
nurses, and emergency medical systems, a statewide bar |
association, a national bar association with an Illinois |
chapter that concentrates in elder and disability law, a |
not-for-profit organ procurement organization that coordinates |
organ and tissue donation, a statewide committee or group |
responsible for stakeholder education about POLST issues, and a |
statewide organization representing hospitals, the Department |
of Public Health shall study the feasibility of creating a |
|
statewide registry of advance directives and POLST forms. The |
registry would allow residents of this State to submit the |
forms and for the forms to be made available to health care |
providers and professionals in a timely manner for the |
provision of care or services. This study must be filed with |
the General Assembly on or before January 1, 2021. |
(c) (Blank). |
(d) The Department of Public Health shall publish the |
Department of Public Health Uniform POLST form reflecting the |
changes made by this amendatory Act of the 98th General |
Assembly no later than January 1, 2015.
|
(Source: P.A. 99-319, eff. 1-1-16; 99-581, eff. 1-1-17; |
100-513, eff. 1-1-18.)
|
Section 15. The Illinois Living Will Act is amended by |
changing Sections 2, 5, and 9 as follows:
|
(755 ILCS 35/2) (from Ch. 110 1/2, par. 702)
|
Sec. 2. Definitions: |
(a) "Attending physician" means the physician selected by, |
or assigned
to, the patient who has primary responsibility for |
the treatment and care
of the patient.
|
(b) "Declaration" means a witnessed document in writing, in |
a hard copy or electronic format, voluntarily
executed by the |
declarant in accordance with the requirements of Section 3.
|
(c) "Health-care provider" means a person who is licensed, |
|
certified
or otherwise authorized by the law of this State to |
administer health care
in the ordinary course of business or |
practice of a profession.
|
(d) "Death delaying procedure" means any medical procedure |
or intervention
which, when applied to a qualified patient, in |
the judgement of the attending
physician would serve only to |
postpone the moment of death. In
appropriate circumstances, |
such procedures include, but are not limited to,
assisted |
ventilation, artificial kidney treatments, intravenous feeding |
or
medication, blood transfusions, tube feeding and other |
procedures of
greater or lesser magnitude that serve only to |
delay death. However, this
Act does not affect the |
responsibility of the attending physician or other
health care |
provider to provide treatment for a patient's comfort care or
|
alleviation of pain. Nutrition and hydration shall not be |
withdrawn or
withheld from a qualified patient if the |
withdrawal or withholding would
result in death solely from |
dehydration or starvation rather than from the
existing |
terminal condition.
|
(e) "Person" means an individual, corporation, business |
trust,
estate, trust, partnership, association, government, |
governmental
subdivision or agency, or any other legal entity.
|
(f) "Physician" means a person licensed to practice |
medicine in
all its branches.
|
(g) "Qualified patient" means a patient who has executed a |
declaration
in accordance with this Act and who has been |
|
diagnosed and verified in
writing to be afflicted with a |
terminal condition by his or her attending
physician who has |
personally examined the patient. A qualified patient
has the |
right to make decisions regarding death delaying procedures as |
long
as he or she is able to do so.
|
(h) "Terminal condition" means an incurable and |
irreversible condition
which is such that death is imminent and |
the application of death delaying
procedures serves only to |
prolong the dying process.
|
(Source: P.A. 95-331, eff. 8-21-07.)
|
(755 ILCS 35/5) (from Ch. 110 1/2, par. 705)
|
Sec. 5. Revocation. (a) A declaration may be revoked at any |
time by
the declarant, without regard to declarant's mental or |
physical condition,
by any of the following methods:
|
(1) By being obliterated, burnt, torn or otherwise |
destroyed or defaced
in a manner indicating intention to |
cancel;
|
(2) By a written revocation of the declaration signed and |
dated by the
declarant or person acting at the direction of the |
declarant, regardless of whether the written revocation is in |
electronic or hard copy format; or
|
(3) By an a oral or any other expression of the intent to |
revoke the
declaration, in the presence of a witness 18 years |
of age or older who
signs and dates a writing confirming that |
such expression of intent was made; or .
|
|
(4) For an electronic declaration, by deleting in a manner |
indicating the intention to revoke. An electronic declaration |
may be revoked electronically using a generic, |
technology-neutral system in which each user is assigned a |
unique identifier that is securely maintained and in a manner |
that meets the regulatory requirements for a digital or |
electronic signature. Compliance with the standards defined in |
the Electronic Commerce Security Act or the implementing rules |
of the Hospital Licensing Act for medical record entry |
authentication for author validation of the documentation, |
content accuracy, and completeness meets this standard. |
(b) A revocation is effective upon communication to the |
attending
physician by the declarant or by another who
|
witnessed the revocation. The attending physician shall record |
in
the patient's medical record the time and date when and
the |
place where he or she received notification of the revocation.
|
(c) There shall be no criminal or civil liability on the
|
part of any person for failure to act upon a revocation made |
pursuant to
this Section unless that person has actual |
knowledge of the revocation.
|
(Source: P.A. 85-860.)
|
(755 ILCS 35/9) (from Ch. 110 1/2, par. 709)
|
Sec. 9. General provisions. (a) The withholding or |
withdrawal of
death delaying procedures from a qualified |
patient in accordance with the
provisions of this Act shall |
|
not, for any purpose, constitute a suicide.
|
(b) The making of a declaration pursuant to Section 3 shall |
not affect
in any manner the sale, procurement, or issuance of |
any policy of life
insurance, nor shall it be deemed to modify |
the terms of an existing policy
of life insurance. No policy of |
life insurance shall be legally impaired
or invalidated in any |
manner by the withholding or withdrawal of death
delaying |
procedures from an insured qualified patient, notwithstanding |
any
term of the policy to the contrary.
|
(c) No physician, health care facility, or other health |
care provider,
and no health care service plan, health |
maintenance organization, insurer
issuing disability |
insurance, self-insured employee employe welfare benefit plan,
|
nonprofit medical service corporation or mutual nonprofit |
hospital service
corporation shall require any person to |
execute a declaration as a
condition for being insured for, or |
receiving, health care services.
|
(d) Nothing in this Act shall impair or supersede any legal |
right or legal
responsibility which any person may have to |
effect the withholding or
withdrawal of death delaying |
procedures in any lawful manner. In such
respect the provisions |
of this Act are cumulative.
|
(e) This Act shall create no presumption concerning the |
intention of an
individual who has not executed a declaration |
to consent to the use or
withholding of death delaying |
procedures in the event of a terminal condition.
|
|
(f) Nothing in this Act shall be construed to condone, |
authorize or approve
mercy killing or to permit any affirmative |
or deliberate act or omission
to end life other than to permit |
the natural process of dying as provided in this Act.
|
(g) An instrument executed before the effective date of |
this Act
that substantially complies with subsection paragraph |
(e) of Section 3 shall be given
effect pursuant to the |
provisions of this Act.
|
(h) A declaration executed in another state in compliance |
with the
law of that state or this State is validly executed |
for purposes of this
Act, and such declaration shall be applied |
in accordance with the
provisions of this Act.
|
(i) Documents, writings, forms, and copies referred to in |
this Act may be in hard copy or electronic format. Nothing in |
this Act is intended to prevent the population of a |
declaration, document, writing, or form with electronic data. |
Electronic documents under this Act may be created, signed, or |
revoked electronically using a generic, technology-neutral |
system in which each user is assigned a unique identifier that |
is securely maintained and in a manner that meets the |
regulatory requirements for a digital or electronic signature. |
Compliance with the standards defined in the Electronic |
Commerce Security Act or the implementing rules of the Hospital |
Licensing Act for medical record entry authentication for |
author validation of the documentation, content accuracy, and |
completeness meets this standard. |
|
(Source: P.A. 85-860.)
|
Section 20. The Health Care Surrogate Act is amended by |
adding Section 70 as follows:
|
(755 ILCS 40/70 new) |
Sec. 70. Format. The affidavit, medical record, documents, |
and forms referred to in this Act may be in hard copy or |
electronic format. Nothing in this Act is intended to prevent |
the population of an affidavit, medical record, document, or |
form with electronic data. A living will, mental health |
treatment preferences declaration, practitioner orders for |
life-sustaining treatment (POLST), or power of attorney for |
health care that is populated with electronic data is |
operative. Electronic documents under this Act may be created, |
signed, or revoked electronically using a generic, |
technology-neutral system in which each user is assigned a |
unique identifier that is securely maintained and in a manner |
that meets the regulatory requirements for a digital or |
electronic signature. Compliance with the standards defined in |
the Electronic Commerce Security Act or the implementing rules |
of the Hospital Licensing Act for medical record entry |
authentication for author validation of the documentation, |
content accuracy, and completeness meets this standard.
|
Section 25. The Mental Health Treatment Preference |
|
Declaration Act is amended by changing Sections 5, 20, and 50 |
and by adding Section 23 as follows:
|
(755 ILCS 43/5)
|
Sec. 5. Definitions. As used in this Act:
|
(1) "Adult" shall have the same meaning as provided in |
Section 10 of the
Health Care Surrogate Act.
|
(2) "Attending physician" shall have the same meaning as |
provided in
Section 10 of the Healthcare Surrogate Act.
|
(3) "Attorney-in-fact" means
an adult validly appointed |
under this Act to make mental health treatment
decisions for a |
principal under a declaration for mental health treatment and
|
also means an alternative attorney-in-fact.
|
(4) "Declaration" means a document, in hard copy or |
electronic format, making a declaration of preferences or
|
instructions regarding mental health treatment.
|
(5) "Incapable" means that, in the opinion of 2 physicians |
or the court, a
person's ability to
receive and evaluate |
information effectively or communicate decisions is
impaired |
to such an extent that the person currently lacks the capacity |
to make
mental health treatment decisions.
|
(6) "Mental Health Facility" shall have the same meaning as |
provided in
Section 1-114 of the Mental Health and |
Developmental Disabilities Code.
|
(7) "Mental health treatment" means electroconvulsive |
treatment, treatment
of mental illness with psychotropic |
|
medication, and admission to and retention
in a mental health |
facility for a period not to exceed 17 days for care or
|
treatment of mental illness.
|
(8) "Physician" means a physician or psychiatrist as |
defined in Sections
1-120 and 1-121, respectively, of the |
Mental Health and Developmental
Disabilities Code.
|
(9) "Principal" means the person making a declaration for |
his or her
personal mental health treatment.
|
(10) "Provider" means any mental health facility or any |
other person which
is devoted in whole or part to providing |
mental health services.
|
(Source: P.A. 89-439, eff. 6-1-96.)
|
(755 ILCS 43/20)
|
Sec. 20. Signatures required. |
(a) A declaration is effective only if it is
signed by the |
principal, and 2 competent adult witnesses. The witnesses must
|
attest that the principal is known to them, signed the |
declaration in their
presence and appears to be of sound mind |
and not under duress, fraud or undue
influence. Persons |
specified in Section 65 of this Act may not act as
witnesses.
|
(b) The signature and execution requirements set forth in |
this Act are satisfied by: (i) written signatures or initials; |
or (ii) electronic signatures or computer-generated signature |
codes. Electronic documents under this Act may be created, |
signed, or revoked electronically using a generic, |
|
technology-neutral system in which each user is assigned a |
unique identifier that is securely maintained and in a manner |
that meets the regulatory requirements for a digital or |
electronic signature. Compliance with the standards defined in |
the Electronic Commerce Security Act or the implementing rules |
of the Hospital Licensing Act for medical record entry |
authentication for author validation of the documentation, |
content accuracy, and completeness meets this standard. |
(Source: P.A. 89-439, eff. 6-1-96.)
|
(755 ILCS 43/23 new) |
Sec. 23. Format. Documents, writings, and forms referred to |
in this Act may be in hard copy or electronic format. Nothing |
in this Act is intended to prevent the population of a |
declaration, document, writing, or form with electronic data.
|
(755 ILCS 43/50)
|
Sec. 50. Revocation. A declaration may be revoked in whole |
or in part by
written statement at any time by the principal if |
the principal is not
incapable, regardless of whether the |
written revocation is in an electronic or hard copy format. A |
written statement of revocation is effective when signed by the
|
principal and a physician and the principal delivers the |
revocation to the
attending physician. An electronic |
declaration may be revoked electronically using a generic, |
technology-neutral system in which each user is assigned a |
|
unique identifier that is securely maintained and in a manner |
that meets the regulatory requirements for a digital or |
electronic signature. Compliance with the standards defined in |
the Electronic Commerce Security Act or the implementing rules |
of the Hospital Licensing Act for medical record entry |
authentication for author validation of the documentation, |
content accuracy, and completeness meets this standard. The |
attending physician shall note the revocation as part
of the |
principal's medical record.
|
(Source: P.A. 89-439, eff. 6-1-96.)
|
Section 30. The Illinois Power of Attorney Act is amended |
by changing Sections 4-4, 4-6, 4-9, and 4-10 and by adding |
Section 4-4.1 as follows:
|
(755 ILCS 45/4-4) (from Ch. 110 1/2, par. 804-4)
|
Sec. 4-4. Definitions. As used in this Article:
|
(a) "Attending physician" means the physician who has |
primary
responsibility at the time of reference for the |
treatment and care of the patient.
|
(b) "Health care" means any care, treatment, service or |
procedure to
maintain, diagnose, treat or provide for the |
patient's physical or mental
health or personal care.
|
(c) "Health care agency" means an agency governing any type |
of health
care, anatomical gift, autopsy or disposition of |
remains for and on behalf
of a patient and refers, in either |
|
hard copy or electronic format, to the power of attorney or |
other written
instrument defining the agency or the agency, |
itself, as appropriate to the context.
|
(d) "Health care provider", "health care professional", or |
"provider" means the attending physician
and any other person |
administering health care to the patient at the time
of |
reference who is licensed, certified, or otherwise authorized |
or
permitted by law to administer health care in the ordinary |
course of
business or the practice of a profession, including |
any person employed by
or acting for any such authorized |
person.
|
(e) "Patient" means the principal or, if the agency governs |
health care
for a minor child of the principal, then the child.
|
(e-5) "Health care agent" means an individual at least 18 |
years old designated by the principal to make health care |
decisions of any type, including, but not limited to, |
anatomical gift, autopsy, or disposition of remains for and on |
behalf of the individual. A health care agent is a personal |
representative under state and federal law. The health care |
agent has the authority of a personal representative under both |
state and federal law unless restricted specifically by the |
health care agency. |
(f) (Blank). |
(g) (Blank). |
(h) (Blank). |
(Source: P.A. 98-1113, eff. 1-1-15.)
|
|
(755 ILCS 45/4-4.1 new) |
Sec. 4-4.1. Format. Documents, writings, forms, and copies |
referred to in this Article may be in hard copy or electronic |
format. Nothing in this Article is intended to prevent the |
population of a written instrument of a health care agency, |
document, writing, or form with electronic data.
|
(755 ILCS 45/4-6) (from Ch. 110 1/2, par. 804-6)
|
Sec. 4-6. Revocation and amendment of health care agencies.
|
(a) Every health care agency may be revoked by the |
principal at any
time, without regard to the principal's mental |
or physical condition, by
any of the following methods:
|
1. By being obliterated, burnt, torn or otherwise destroyed |
or defaced
in a manner indicating intention to revoke;
|
2. By a written revocation of the agency signed and dated |
by the
principal or person acting at the direction of the |
principal, regardless of whether the written revocation is in |
an electronic or hard copy format; or
|
3. By an oral or any other expression of the intent to |
revoke the agency
in the presence of a witness 18 years of age |
or older who signs and dates a
writing confirming that such |
expression of intent was made; or .
|
4. For an electronic health care agency, by deleting in a |
manner indicating the intention to revoke. An electronic health |
care agency may be revoked electronically using a generic, |
|
technology-neutral system in which each user is assigned a |
unique identifier that is securely maintained and in a manner |
that meets the regulatory requirements for a digital or |
electronic signature. Compliance with the standards defined in |
the Electronic Commerce Security Act or the implementing rules |
of the Hospital Licensing Act for medical record entry |
authentication for author validation of the documentation, |
content accuracy, and completeness meets this standard. |
(b) Every health care agency may be amended at any time by |
a written
amendment signed and dated by the principal or person |
acting at the
direction of the principal.
|
(c) Any person, other than the agent, to whom a revocation |
or amendment is
communicated or delivered shall make all |
reasonable efforts to inform the
agent of that fact as promptly |
as possible.
|
(Source: P.A. 85-701.)
|
(755 ILCS 45/4-9) (from Ch. 110 1/2, par. 804-9)
|
Sec. 4-9. Penalties. All persons shall be subject to the |
following
sanctions in relation to health care agencies, in |
addition to all other
sanctions applicable under any other law |
or rule of professional conduct:
|
(a) Any person shall be civilly liable who, without the |
principal's
consent: (i) , wilfully conceals, cancels, or |
alters a health care agency or any
amendment or revocation of |
the agency; (ii) or who falsifies or forges a health
care |
|
agency, amendment, or revocation; or (iii) enters information |
in an electronic system under the persona of the principal.
|
(b) A person who falsifies or forges a health care agency, |
enters information in an electronic system under the persona of |
the principal, or wilfully
conceals or withholds personal |
knowledge of an amendment or revocation of a
health care agency |
with the intent to cause a withholding or withdrawal of
|
life-sustaining or death-delaying procedures contrary to the |
intent of the
principal and thereby, because of such act, |
directly causes life-sustaining
or death-delaying procedures |
to be withheld or withdrawn and death to the
patient to be |
hastened shall be subject to prosecution for involuntary |
manslaughter.
|
(c) Any person who requires or prevents execution of a |
health care
agency as a condition of insuring or providing any |
type of health care
services to the patient shall be civilly |
liable and guilty of a Class A
misdemeanor.
|
(Source: P.A. 85-701.)
|
(755 ILCS 45/4-10) (from Ch. 110 1/2, par. 804-10)
|
Sec. 4-10. Statutory short form power of attorney for |
health care.
|
(a) The form prescribed in this Section (sometimes also |
referred to in this Act as the
"statutory health care power") |
may be used to grant an agent powers with
respect to the |
principal's own health care; but the statutory health care
|
|
power is not intended to be exclusive nor to cover delegation |
of a parent's
power to control the health care of a minor |
child, and no provision of this
Article shall be construed to |
invalidate or bar use by the principal of any
other or
|
different form of power of attorney for health care. |
Nonstatutory health
care powers must be
executed by the |
principal, designate the agent and the agent's powers, and
|
comply with the limitations in Section 4-5 of this Article, but |
they need not be witnessed or
conform in any other respect to |
the statutory health care power. |
No specific format is required for the statutory health |
care power of attorney other than the notice must precede the |
form. The statutory health care power may be included in or
|
combined with any
other form of power of attorney governing |
property or other matters.
|
The signature and execution requirements set forth in this |
Article are satisfied by: (i) written signatures or initials; |
or (ii) electronic signatures or computer-generated signature |
codes. Electronic documents under this Act may be created, |
signed, or revoked electronically using a generic, |
technology-neutral system in which each user is assigned a |
unique identifier that is securely maintained and in a manner |
that meets the regulatory requirements for a digital or |
electronic signature. Compliance with the standards defined in |
the Electronic Commerce Security Act or the implementing rules |
of the Hospital Licensing Act for medical record entry |
|
authentication for author validation of the documentation, |
content accuracy, and completeness meets this standard. |
(b) The Illinois Statutory Short Form Power of Attorney for |
Health Care shall be substantially as follows:
|
NOTICE TO THE INDIVIDUAL SIGNING |
THE POWER OF ATTORNEY FOR HEALTH CARE |
No one can predict when a serious illness or accident might |
occur. When it does, you may need someone else to speak or make |
health care decisions for you. If you plan now, you can |
increase the chances that the medical treatment you get will be |
the treatment you want. |
In Illinois, you can choose someone to be your "health care |
agent". Your agent is the person you trust to make health care |
decisions for you if you are unable or do not want to make them |
yourself. These decisions should be based on your personal |
values and wishes. |
It is important to put your choice of agent in writing. The |
written form is often called an "advance directive". You may |
use this form or another form, as long as it meets the legal |
requirements of Illinois. There are many written and on-line |
resources to guide you and your loved ones in having a |
conversation about these issues. You may find it helpful to |
look at these resources while thinking about and discussing |
your advance directive.
|
|
WHAT ARE THE THINGS I WANT MY |
HEALTH CARE AGENT TO KNOW? |
The selection of your agent should be considered carefully, |
as your agent will have the ultimate decision-making decision |
making authority once this document goes into effect, in most |
instances after you are no longer able to make your own |
decisions. While the goal is for your agent to make decisions |
in keeping with your preferences and in the majority of |
circumstances that is what happens, please know that the law |
does allow your agent to make decisions to direct or refuse |
health care interventions or withdraw treatment. Your agent |
will need to think about conversations you have had, your |
personality, and how you handled important health care issues |
in the past. Therefore, it is important to talk with your agent |
and your family about such things as: |
(i) What is most important to you in your life? |
(ii) How important is it to you to avoid pain and |
suffering? |
(iii) If you had to choose, is it more important to you |
to live as long as possible, or to avoid prolonged |
suffering or disability? |
(iv) Would you rather be at home or in a hospital for |
the last days or weeks of your life? |
(v) Do you have religious, spiritual, or cultural |
beliefs that you want your agent and others to consider? |
(vi) Do you wish to make a significant contribution to |
|
medical science after your death through organ or whole |
body donation? |
(vii) Do you have an existing advance advanced |
directive, such as a living will, that contains your |
specific wishes about health care that is only delaying |
your death? If you have another advance directive, make |
sure to discuss with your agent the directive and the |
treatment decisions contained within that outline your |
preferences. Make sure that your agent agrees to honor the |
wishes expressed in your advance directive.
|
WHAT KIND OF DECISIONS CAN MY AGENT MAKE? |
If there is ever a period of time when your physician |
determines that you cannot make your own health care decisions, |
or if you do not want to make your own decisions, some of the |
decisions your agent could make are to: |
(i) talk with physicians and other health care |
providers about your condition. |
(ii) see medical records and approve who else can see |
them. |
(iii) give permission for medical tests, medicines, |
surgery, or other treatments. |
(iv) choose where you receive care and which physicians |
and others provide it. |
(v) decide to accept, withdraw, or decline treatments |
designed to keep you alive if you are near death or not |
|
likely to recover. You may choose to include guidelines |
and/or restrictions to your agent's authority. |
(vi) agree or decline to donate your organs or your |
whole body if you have not already made this decision |
yourself. This could include donation for transplant, |
research, and/or education. You should let your agent know |
whether you are registered as a donor in the First Person |
Consent registry maintained by the Illinois Secretary of |
State or whether you have agreed to donate your whole body |
for medical research and/or education. |
(vii) decide what to do with your remains after you |
have died, if you have not already made plans. |
(viii) talk with your other loved ones to help come to |
a decision (but your designated agent will have the final |
say over your other loved ones). |
Your agent is not automatically responsible for your health |
care expenses.
|
WHOM SHOULD I CHOOSE TO BE MY HEALTH CARE AGENT? |
You can pick a family member, but you do not have to. Your |
agent will have the responsibility to make medical treatment |
decisions, even if other people close to you might urge a |
different decision. The selection of your agent should be done |
carefully, as he or she will have ultimate decision-making |
authority for your treatment decisions once you are no longer |
able to voice your preferences. Choose a family member, friend, |
|
or other person who: |
(i) is at least 18 years old; |
(ii) knows you well; |
(iii) you trust to do what is best for you and is |
willing to carry out your wishes, even if he or she may not |
agree with your wishes; |
(iv) would be comfortable talking with and questioning |
your physicians and other health care providers; |
(v) would not be too upset to carry out your wishes if |
you became very sick; and |
(vi) can be there for you when you need it and is |
willing to accept this important role.
|
WHAT IF MY AGENT IS NOT AVAILABLE OR IS |
UNWILLING TO MAKE DECISIONS FOR ME? |
If the person who is your first choice is unable to carry |
out this role, then the second agent you chose will make the |
decisions; if your second agent is not available, then the |
third agent you chose will make the decisions. The second and |
third agents are called your successor agents and they function |
as back-up agents to your first choice agent and may act only |
one at a time and in the order you list them.
|
WHAT WILL HAPPEN IF I DO NOT |
CHOOSE A HEALTH CARE AGENT? |
If you become unable to make your own health care decisions |
|
and have not named an agent in writing, your physician and |
other health care providers will ask a family member, friend, |
or guardian to make decisions for you. In Illinois, a law |
directs which of these individuals will be consulted. In that |
law, each of these individuals is called a "surrogate". |
There are reasons why you may want to name an agent rather |
than rely on a surrogate: |
(i) The person or people listed by this law may not be |
who you would want to make decisions for you. |
(ii) Some family members or friends might not be able |
or willing to make decisions as you would want them to. |
(iii) Family members and friends may disagree with one |
another about the best decisions. |
(iv) Under some circumstances, a surrogate may not be |
able to make the same kinds of decisions that an agent can |
make.
|
WHAT IF THERE IS NO ONE AVAILABLE |
WHOM I TRUST TO BE MY AGENT? |
In this situation, it is especially important to talk to |
your physician and other health care providers and create |
written guidance about what you want or do not want, in case |
you are ever critically ill and cannot express your own wishes. |
You can complete a living will. You can also write your wishes |
down and/or discuss them with your physician or other health |
care provider and ask him or her to write it down in your |
|
chart. You might also want to use written or on-line resources |
to guide you through this process.
|
WHAT DO I DO WITH THIS FORM ONCE I COMPLETE IT? |
Follow these instructions after you have completed the |
form: |
(i) Sign the form in front of a witness. See the form |
for a list of who can and cannot witness it. |
(ii) Ask the witness to sign it, too. |
(iii) There is no need to have the form notarized. |
(iv) Give a copy to your agent and to each of your |
successor agents. |
(v) Give another copy to your physician. |
(vi) Take a copy with you when you go to the hospital. |
(vii) Show it to your family and friends and others who |
care for you.
|
WHAT IF I CHANGE MY MIND? |
You may change your mind at any time. If you do, tell |
someone who is at least 18 years old that you have changed your |
mind, and/or destroy your document and any copies. If you wish, |
fill out a new form and make sure everyone you gave the old |
form to has a copy of the new one, including, but not limited |
to, your agents and your physicians.
|
WHAT IF I DO NOT WANT TO USE THIS FORM? |
|
In the event you do not want to use the Illinois statutory |
form provided here, any document you complete must be executed |
by you, designate an agent who is over 18 years of age and not |
prohibited from serving as your agent, and state the agent's |
powers, but it need not be witnessed or conform in any other |
respect to the statutory health care power. |
If you have questions about the use of any form, you may |
want to consult your physician, other health care provider, |
and/or an attorney.
|
MY POWER OF ATTORNEY FOR HEALTH CARE
|
THIS POWER OF ATTORNEY REVOKES ALL PREVIOUS POWERS OF ATTORNEY |
FOR HEALTH CARE. (You must sign this form and a witness must |
also sign it before it is valid)
|
My name (Print your full name):.......... |
My address:..................................................
|
I WANT THE FOLLOWING PERSON TO BE MY HEALTH CARE AGENT |
(an agent is your personal representative under state and |
federal law): |
(Agent name)................. |
(Agent address)............. |
(Agent phone number).........................................
|
|
(Please check box if applicable) .... If a guardian of my |
person is to be appointed, I nominate the agent acting under |
this power of attorney as guardian.
|
SUCCESSOR HEALTH CARE AGENT(S) (optional): |
If the agent I selected is unable or does not want to make |
health care decisions for me, then I request the person(s) I |
name below to be my successor health care agent(s). Only one |
person at a time can serve as my agent (add another page if you |
want to add more successor agent names): |
..................... |
(Successor agent #1 name, address and phone number) |
.......... |
(Successor agent #2 name, address and phone number)
|
MY AGENT CAN MAKE HEALTH CARE DECISIONS FOR ME, INCLUDING: |
(i) Deciding to accept, withdraw or decline treatment |
for any physical or mental condition of mine, including |
life-and-death decisions. |
(ii) Agreeing to admit me to or discharge me from any |
hospital, home, or other institution, including a mental |
health facility. |
(iii) Having complete access to my medical and mental |
health records, and sharing them with others as needed, |
including after I die. |
(iv) Carrying out the plans I have already made, or, if |
|
I have not done so, making decisions about my body or |
remains, including organ, tissue or whole body donation, |
autopsy, cremation, and burial. |
The above grant of power is intended to be as broad as |
possible so that my agent will have the authority to make any |
decision I could make to obtain or terminate any type of health |
care, including withdrawal of nutrition and hydration and other |
life-sustaining measures.
|
I AUTHORIZE MY AGENT TO (please check any one box): |
.... Make decisions for me only when I cannot make them for |
myself. The physician(s) taking care of me will determine |
when I lack this ability. |
(If no box is checked, then the box above shall be |
implemented.)
OR |
.... Make decisions for me only when I cannot make them for |
myself. The physician(s) taking care of me will determine |
when I lack this ability. Starting now, for the purpose of |
assisting me with my health care plans and decisions, my |
agent shall have complete access to my medical and mental |
health records, the authority to share them with others as |
needed, and the complete ability to communicate with my |
personal physician(s) and other health care providers, |
including the ability to require an opinion of my physician |
as to whether I lack the ability to make decisions for |
myself. OR |
|
.... Make decisions for me starting now and continuing |
after I am no longer able to make them for myself. While I |
am still able to make my own decisions, I can still do so |
if I want to.
|
The subject of life-sustaining treatment is of particular |
importance. Life-sustaining treatments may include tube |
feedings or fluids through a tube, breathing machines, and CPR. |
In general, in making decisions concerning life-sustaining |
treatment, your agent is instructed to consider the relief of |
suffering, the quality as well as the possible extension of |
your life, and your previously expressed wishes. Your agent |
will weigh the burdens versus benefits of proposed treatments |
in making decisions on your behalf. |
Additional statements concerning the withholding or |
removal of life-sustaining treatment are described below. |
These can serve as a guide for your agent when making decisions |
for you. Ask your physician or health care provider if you have |
any questions about these statements.
|
SELECT ONLY ONE STATEMENT BELOW THAT BEST EXPRESSES YOUR WISHES |
(optional): |
.... The quality of my life is more important than the |
length of my life. If I am unconscious and my attending |
physician believes, in accordance with reasonable medical |
standards, that I will not wake up or recover my ability to |
|
think, communicate with my family and friends, and |
experience my surroundings, I do not want treatments to |
prolong my life or delay my death, but I do want treatment |
or care to make me comfortable and to relieve me of pain. |
.... Staying alive is more important to me, no matter how |
sick I am, how much I am suffering, the cost of the |
procedures, or how unlikely my chances for recovery are. I |
want my life to be prolonged to the greatest extent |
possible in accordance with reasonable medical standards.
|
SPECIFIC LIMITATIONS TO MY AGENT'S DECISION-MAKING AUTHORITY: |
The above grant of power is intended to be as broad as |
possible so that your agent will have the authority to make any |
decision you could make to obtain or terminate any type of |
health care. If you wish to limit the scope of your agent's |
powers or prescribe special rules or limit the power to |
authorize autopsy or dispose of remains, you may do so |
specifically in this form. |
| .................................. |
| ..............................
|
My signature:.................. |
Today's date:................................................
|
HAVE YOUR WITNESS AGREE TO WHAT IS WRITTEN BELOW, AND THEN |
COMPLETE THE SIGNATURE PORTION: |
|
I am at least 18 years old. (check one of the options |
below): |
.... I saw the principal sign this document, or |
.... the principal told me that the signature or mark on |
the principal signature line is his or hers. |
I am not the agent or successor agent(s) named in this |
document. I am not related to the principal, the agent, or the |
successor agent(s) by blood, marriage, or adoption. I am not |
the principal's physician, advanced practice registered nurse, |
dentist, podiatric physician, optometrist, psychologist, or a |
relative of one of those individuals. I am not an owner or |
operator (or the relative of an owner or operator) of the |
health care facility where the principal is a patient or |
resident. |
Witness printed name:............ |
Witness address:.............. |
Witness signature:............... |
Today's date:................................................
|
(c) The statutory short form power of attorney for health |
care (the
"statutory health care power") authorizes the agent |
to make any and all
health care decisions on behalf of the |
principal which the principal could
make if present and under |
no disability, subject to any limitations on the
granted powers |
that appear on the face of the form, to be exercised in such
|
manner as the agent deems consistent with the intent and |
|
desires of the
principal. The agent will be under no duty to |
exercise granted powers or
to assume control of or |
responsibility for the principal's health care;
but when |
granted powers are exercised, the agent will be required to use
|
due care to act for the benefit of the principal in accordance |
with the
terms of the statutory health care power and will be |
liable
for negligent exercise. The agent may act in person or |
through others
reasonably employed by the agent for that |
purpose
but may not delegate authority to make health care |
decisions. The agent
may sign and deliver all instruments, |
negotiate and enter into all
agreements and do all other acts |
reasonably necessary to implement the
exercise of the powers |
granted to the agent. Without limiting the
generality of the |
foregoing, the statutory health care power shall include
the |
following powers, subject to any limitations appearing on the |
face of the form:
|
(1) The agent is authorized to give consent to and |
authorize or refuse,
or to withhold or withdraw consent to, |
any and all types of medical care,
treatment or procedures |
relating to the physical or mental health of the
principal, |
including any medication program, surgical procedures,
|
life-sustaining treatment or provision of food and fluids |
for the principal.
|
(2) The agent is authorized to admit the principal to |
or discharge the
principal from any and all types of |
hospitals, institutions, homes,
residential or nursing |
|
facilities, treatment centers and other health care
|
institutions providing personal care or treatment for any |
type of physical
or mental condition. The agent shall have |
the same right to visit the
principal in the hospital or |
other institution as is granted to a spouse or
adult child |
of the principal, any rule of the institution to the |
contrary
notwithstanding.
|
(3) The agent is authorized to contract for any and all |
types of health
care services and facilities in the name of |
and on behalf of the principal
and to bind the principal to |
pay for all such services and facilities,
and to have and |
exercise those powers over the principal's property as are
|
authorized under the statutory property power, to the |
extent the agent
deems necessary to pay health care costs; |
and
the agent shall not be personally liable for any |
services or care contracted
for on behalf of the principal.
|
(4) At the principal's expense and subject to |
reasonable rules of the
health care provider to prevent |
disruption of the principal's health care,
the agent shall |
have the same right the principal has to examine and copy
|
and consent to disclosure of all the principal's medical |
records that the agent deems
relevant to the exercise of |
the agent's powers, whether the records
relate to mental |
health or any other medical condition and whether they are |
in
the possession of or maintained by any physician, |
psychiatrist,
psychologist, therapist, hospital, nursing |
|
home or other health care
provider. The authority under |
this paragraph (4) applies to any information governed by |
the Health Insurance Portability and Accountability Act of |
1996 ("HIPAA") and regulations thereunder. The agent |
serves as the principal's personal representative, as that |
term is defined under HIPAA and regulations thereunder.
|
(5) The agent is authorized: to direct that an autopsy |
be made pursuant
to Section 2 of the Autopsy Act "An Act in |
relation to autopsy of dead bodies", approved
August 13, |
1965, including all amendments;
to make a disposition of |
any
part or all of the principal's body pursuant to the |
Illinois Anatomical Gift
Act, as now or hereafter amended; |
and to direct the disposition of the
principal's remains. |
(6) At any time during which there is no executor or |
administrator appointed for the principal's estate, the |
agent is authorized to continue to pursue an application or |
appeal for government benefits if those benefits were |
applied for during the life of the principal.
|
(d) A physician may determine that the principal is unable |
to make health care decisions for himself or herself only if |
the principal lacks decisional capacity, as that term is |
defined in Section 10 of the Health Care Surrogate Act. |
(e) If the principal names the agent as a guardian on the |
statutory short form, and if a court decides that the |
appointment of a guardian will serve the principal's best |
interests and welfare, the court shall appoint the agent to |
