Advanced legal planning for elders consists of three main elements: a Will, a "Durable/Enduring Power of Attorney," and a "Power of Attorney for Issuing Directives as to the Medical Care of a Terminally-Ill Patient"—which is the Israeli version of a "Living Will" (a legal document that specifies the type of medical care that an individual does or does not want to get in the event he or she is unable to communicate his or her wishes).
The Terminally Ill Patient Law deals with terminally ill patients who are diagnosed with an incurable disease at the end of their days. A "Terminally Ill Patient" is defined by the law as a patient who is sick with an incurable disease and whose life expectancy does not exceed six months, even if receiving medical care.
The law requires the medical staff to provide palliative care to a terminally ill patient. The law also regulates the rules whereby a person may direct in advance not to receive medical care if he/she is terminally ill and incompetent, in order to avoid prolonged suffering. The law states the conditions and restrictions to avoid medical care and prohibits actively causing death or assisting in suicide. Any person competent to make decisions, whether ill or healthy, is allowed to provide Advance Medical Directives and/or to execute a Power of Attorney or both, as they choose.
As long as a person is lucid and fully conscious, his/her wishes takes precedence. Advance medical directives or power of attorney appointment will take effect only if the patient becomes incompetent to make decisions.
Power of Attorney for Issuing Directives as to the Medical Care of a Terminally-Ill PatientFor whom is this Power of Attorney intended?
It is intended to be executed by a person who wishes to grant a Power of Attorney to a Trustee who will be qualified to decide, in his/her place, on medical treatment to be provided, or not to be provided, if he/she becomes terminally ill and incompetent.
This legal procedure allows the Principal to grant Powers of Attorney to another person, a Trustee, to speak on his/her behalf when unable to express his/her wishes. The person acting on account of the power of attorney may express the patient's wishes and decisions concerning receipt of or abstention from medical treatments. A Power of Attorney appointment averts differences of opinions between family members and the attending staff and avoids the need to appoint a guardian for the patient's body. A Power of Attorney of this kind applies only to end-of-life medical treatment, and does not apply to any issues regarding finances, day-to-day medical matters, or other personal affairs.
Advanced Directives as to Future Medical Care of a Terminally Il PatientFor whom is these Advanced Directives intended?Advanced Directives as to Future Medical Care may be attached to a Power of Attorney by a person who wishes to provide advance medical directives, in which are detailed his/her wishes concerning future medical care, if he/she becomes terminally ill and incompetent, to avoid medical treatments or to receive any extraordinary life-extending medical treatment.The person providing advance medical directives will detail in writing which treatments he/she wishes to avoid and which to receive. For example, a person may direct in advance to terminate periodical medical treatments such as dialysis, chemotherapy and radiation, if these treatments are related to his/her incurable disease.
Depositing forms at the Central Data Bank
of Advance Medical Directives
A Power of Attorney pursuant to the Terminally Ill Patient Law and/or Advance Medical Directives that are properly filed, oblige the medical staff. Therefore, it is advisable to have the completed forms deposited at the Central Data Bank of Advance Medical Directives at the Ministry of Health. Forms that are deposited at the Ministry of Health will be accessible through the computer system to caregivers at all hospitals.
The Benefits of Executing a Power of Attorney
pursuant to the Terminally Ill Patient Law
Can I give instructions regarding euthanasia?
The law states the conditions and restrictions to avoid medical care and prohibits actively causing death or assisting in suicide. It is not permitted to stop continuous medical treatment that will cause death. It is permitted to refrain from renewing continuous medical treatment that was stopped unintentionally and not contrary to the law, and it is also permitted not to renew periodic medical treatment. It is forbidden to refrain from giving an incompetent patient food and liquids, palliative care and treatment even if he has expressly requested to do so. It is permitted to do so only once being declared a "terminal patient with a life expectancy of two weeks."
Is it possible to revoke or amend the Power of Attorney /
Medical Directives in the future?
Yes, it is possible to nullify and amend them at all points in time.
Whom may I appoint as a trustee?
In principle, any person may be appointed. You may appoint your children: one, some or all of them, and you will dictate the rules which will determine the manner of decision-making amongst them. It is also possible to appoint another person you trust who is not a family member.
May I give guidelines regarding day to day medical treatment?
A Power of Attorney pursuant to the Terminally Ill Patient Law is intended only for medical issues when a person is terminally ill. Therefore, as part of advanced legal planning for the future you should execute a Durable/Enduring Power of Attorney in order to cover daily medical treatment and "on-going medical issues."
For more information regarding advanced legal planning for elders, please see www.BenChorin.com