[ Search ] [ Legislation ] [ Bill Summary ]
[ Home ] [ Back ] [ Bottom ]
| [ Introduced ] | [ Engrossed ] | [ House Amendment 001 ] |
90_SB1592ham002
LRB9011434DJksam01
1 AMENDMENT TO SENATE BILL 1592
2 AMENDMENT NO. . Amend Senate Bill 1592, AS AMENDED,
3 by replacing the title with the following:
4 "AN ACT concerning body organs, amending named Acts.";
5 and
6 below the last line of Section 5, by inserting the following:
7 "Section 10. The Illinois Power of Attorney Act is
8 amended by changing Section 4-10 as follows:
9 (755 ILCS 45/4-10) (from Ch. 110 1/2, par. 804-10)
10 Sec. 4-10. Statutory short form power of attorney for
11 health care. (a) The following form (sometimes also referred
12 to in this Act as the "statutory health care power") may be
13 used to grant an agent powers with respect to the principal's
14 own health care; but the statutory health care power is not
15 intended to be exclusive nor to cover delegation of a
16 parent's power to control the health care of a minor child,
17 and no provision of this Article shall be construed to
18 invalidate or bar use by the principal of any other or
19 different form of power of attorney for health care.
20 Nonstatutory health care powers must be executed by the
21 principal, designate the agent and the agent's powers, and
-2- LRB9011434DJksam01
1 comply with Section 4-5 of this Article, but they need not be
2 witnessed or conform in any other respect to the statutory
3 health care power. When a power of attorney in substantially
4 the following form is used, including the "notice" paragraph
5 at the beginning in capital letters, it shall have the
6 meaning and effect prescribed in this Act. The statutory
7 health care power may be included in or combined with any
8 other form of power of attorney governing property or other
9 matters.
10 "ILLINOIS STATUTORY SHORT FORM POWER OF ATTORNEY FOR
11 HEALTH CARE
12 (NOTICE: THE PURPOSE OF THIS POWER OF ATTORNEY IS TO
13 GIVE THE PERSON YOU DESIGNATE (YOUR "AGENT") BROAD POWERS TO
14 MAKE HEALTH CARE DECISIONS FOR YOU, INCLUDING POWER TO
15 REQUIRE, CONSENT TO OR WITHDRAW ANY TYPE OF PERSONAL CARE OR
16 MEDICAL TREATMENT FOR ANY PHYSICAL OR MENTAL CONDITION AND TO
17 ADMIT YOU TO OR DISCHARGE YOU FROM ANY HOSPITAL, HOME OR
18 OTHER INSTITUTION. THIS FORM DOES NOT IMPOSE A DUTY ON YOUR
19 AGENT TO EXERCISE GRANTED POWERS; BUT WHEN POWERS ARE
20 EXERCISED, YOUR AGENT WILL HAVE TO USE DUE CARE TO ACT FOR
21 YOUR BENEFIT AND IN ACCORDANCE WITH THIS FORM AND KEEP A
22 RECORD OF RECEIPTS, DISBURSEMENTS AND SIGNIFICANT ACTIONS
23 TAKEN AS AGENT. A COURT CAN TAKE AWAY THE POWERS OF YOUR
24 AGENT IF IT FINDS THE AGENT IS NOT ACTING PROPERLY. YOU MAY
25 NAME SUCCESSOR AGENTS UNDER THIS FORM BUT NOT CO-AGENTS, AND
26 NO HEALTH CARE PROVIDER MAY BE NAMED. UNLESS YOU EXPRESSLY
27 LIMIT THE DURATION OF THIS POWER IN THE MANNER PROVIDED
28 BELOW, UNTIL YOU REVOKE THIS POWER OR A COURT ACTING ON YOUR
29 BEHALF TERMINATES IT, YOUR AGENT MAY EXERCISE THE POWERS
30 GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME
31 DISABLED. THE POWERS YOU GIVE YOUR AGENT, YOUR RIGHT TO
32 REVOKE THOSE POWERS AND THE PENALTIES FOR VIOLATING THE LAW
33 ARE EXPLAINED MORE FULLY IN SECTIONS 4-5, 4-6, 4-9 AND
34 4-10(b) OF THE ILLINOIS "POWERS OF ATTORNEY FOR HEALTH CARE
-3- LRB9011434DJksam01
1 LAW" OF WHICH THIS FORM IS A PART (SEE THE BACK OF THIS
2 FORM). THAT LAW EXPRESSLY PERMITS THE USE OF ANY DIFFERENT
3 FORM OF POWER OF ATTORNEY YOU MAY DESIRE. IF THERE IS
4 ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU
5 SHOULD ASK A LAWYER TO EXPLAIN IT TO YOU.)
6 POWER OF ATTORNEY made this .......................day of
7 ................................
8 (month) (year)
9 1. I, ..................................................,
10 (insert name and address of principal)
11 hereby appoint:
12 ............................................................
13 (insert name and address of agent)
14 as my attorney-in-fact (my "agent") to act for me and in my
15 name (in any way I could act in person) to make any and all
16 decisions for me concerning my personal care, medical
17 treatment, hospitalization and health care and to require,
18 withhold or withdraw any type of medical treatment or
19 procedure, even though my death may ensue. My agent shall
20 have the same access to my medical records that I have,
21 including the right to disclose the contents to others. My
22 agent shall also have full power to make a disposition of any
23 part or all of my body for medical purposes, authorize an
24 autopsy and direct the disposition of my remains. Effective
25 upon my death, my agent has the full power to make an
26 anatomical gift of the following (initial one):
27 ....Any organ.
28 ....Entire body.
29 ....Specific organs:................................
30 (THE ABOVE GRANT OF POWER IS INTENDED TO BE AS BROAD AS
31 POSSIBLE SO THAT YOUR AGENT WILL HAVE AUTHORITY TO MAKE ANY
32 DECISION YOU COULD MAKE TO OBTAIN OR TERMINATE ANY TYPE OF
33 HEALTH CARE, INCLUDING WITHDRAWAL OF FOOD AND WATER AND OTHER
34 LIFE-SUSTAINING MEASURES, IF YOUR AGENT BELIEVES SUCH ACTION
-4- LRB9011434DJksam01
1 WOULD BE CONSISTENT WITH YOUR INTENT AND DESIRES. IF YOU
2 WISH TO LIMIT THE SCOPE OF YOUR AGENT'S POWERS OR PRESCRIBE
3 SPECIAL RULES OR LIMIT THE POWER TO MAKE AN ANATOMICAL GIFT,
4 AUTHORIZE AUTOPSY OR DISPOSE OF REMAINS, YOU MAY DO SO IN THE
5 FOLLOWING PARAGRAPHS.)
6 2. The powers granted above shall not include the
7 following powers or shall be subject to the following rules
8 or limitations (here you may include any specific limitations
9 you deem appropriate, such as: your own definition of when
10 life-sustaining measures should be withheld; a direction to
11 continue food and fluids or life-sustaining treatment in all
12 events; or instructions to refuse any specific types of
13 treatment that are inconsistent with your religious beliefs
14 or unacceptable to you for any other reason, such as blood
15 transfusion, electro-convulsive therapy, amputation,
16 psychosurgery, voluntary admission to a mental institution,
17 etc.): ......................................................
18 .............................................................
19 .............................................................
20 .............................................................
21 .............................................................
22 (THE SUBJECT OF LIFE-SUSTAINING TREATMENT IS OF PARTICULAR
23 IMPORTANCE. FOR YOUR CONVENIENCE IN DEALING WITH THAT
24 SUBJECT, SOME GENERAL STATEMENTS CONCERNING THE WITHHOLDING
25 OR REMOVAL OF LIFE-SUSTAINING TREATMENT ARE SET FORTH BELOW.
26 IF YOU AGREE WITH ONE OF THESE STATEMENTS, YOU MAY INITIAL
27 THAT STATEMENT; BUT DO NOT INITIAL MORE THAN ONE):
28 I do not want my life to be prolonged nor do I want
29 life-sustaining treatment to be provided or continued if my
30 agent believes the burdens of the treatment outweigh the
31 expected benefits. I want my agent to consider the relief of
32 suffering, the expense involved and the quality as well as
33 the possible extension of my life in making decisions
34 concerning life-sustaining treatment.
-5- LRB9011434DJksam01
1 Initialed...........................
2 I want my life to be prolonged and I want life-sustaining
3 treatment to be provided or continued unless I am in a coma
4 which my attending physician believes to be irreversible, in
5 accordance with reasonable medical standards at the time of
6 reference. If and when I have suffered irreversible coma, I
7 want life-sustaining treatment to be withheld or
8 discontinued.
9 Initialed...........................
10 I want my life to be prolonged to the greatest extent
11 possible without regard to my condition, the chances I have
12 for recovery or the cost of the procedures.
13 Initialed...........................
14 (THIS POWER OF ATTORNEY MAY BE AMENDED OR REVOKED BY YOU IN
15 THE MANNER PROVIDED IN SECTION 4-6 OF THE ILLINOIS "POWERS OF
16 ATTORNEY FOR HEALTH CARE LAW" (SEE THE BACK OF THIS FORM).
17 ABSENT AMENDMENT OR REVOCATION, THE AUTHORITY GRANTED IN THIS
18 POWER OF ATTORNEY WILL BECOME EFFECTIVE AT THE TIME THIS
19 POWER IS SIGNED AND WILL CONTINUE UNTIL YOUR DEATH, AND
20 BEYOND IF ANATOMICAL GIFT, AUTOPSY OR DISPOSITION OF REMAINS
21 IS AUTHORIZED, UNLESS A LIMITATION ON THE BEGINNING DATE OR
22 DURATION IS MADE BY INITIALING AND COMPLETING EITHER OR BOTH
23 OF THE FOLLOWING:)
24 3. ( ) This power of attorney shall become effective on
25 .............................................................
26 .............................................................
27 (insert a future date or event during your lifetime, such as
28 court determination of your disability, when you want this
29 power to first take effect)
30 4. ( ) This power of attorney shall terminate on ......
31 .............................................................
32 (insert a future date or event, such as court determination
33 of your disability, when you want this power to terminate
34 prior to your death)
-6- LRB9011434DJksam01
1 (IF YOU WISH TO NAME SUCCESSOR AGENTS, INSERT THE NAMES AND
2 ADDRESSES OF SUCH SUCCESSORS IN THE FOLLOWING PARAGRAPH.)
3 5. If any agent named by me shall die, become
4 incompetent, resign, refuse to accept the office of agent or
5 be unavailable, I name the following (each to act alone and
6 successively, in the order named) as successors to such
7 agent:
8 .............................................................
9 .............................................................
10 For purposes of this paragraph 5, a person shall be
11 considered to be incompetent if and while the person is a
12 minor or an adjudicated incompetent or disabled person or the
13 person is unable to give prompt and intelligent consideration
14 to health care matters, as certified by a licensed physician.
15 (IF YOU WISH TO NAME YOUR AGENT AS GUARDIAN OF YOUR PERSON,
16 IN THE EVENT A COURT DECIDES THAT ONE SHOULD BE APPOINTED,
17 YOU MAY, BUT ARE NOT REQUIRED TO, DO SO BY RETAINING THE
18 FOLLOWING PARAGRAPH. THE COURT WILL APPOINT YOUR AGENT IF
19 THE COURT FINDS THAT SUCH APPOINTMENT WILL SERVE YOUR BEST
20 INTERESTS AND WELFARE. STRIKE OUT PARAGRAPH 6 IF YOU DO NOT
21 WANT YOUR AGENT TO ACT AS GUARDIAN.)
22 6. If a guardian of my person is to be appointed, I
23 nominate the agent acting under this power of attorney as
24 such guardian, to serve without bond or security.
25 7. I am fully informed as to all the contents of this
26 form and understand the full import of this grant of powers
27 to my agent.
28 Signed..............................
29 (principal)
30 The principal has had an opportunity to read the above
31 form and has signed the form or acknowledged his or her
32 signature or mark on the form in my presence.
33 .......................... Residing at.......................
34 (witness)
-7- LRB9011434DJksam01
1 (YOU MAY, BUT ARE NOT REQUIRED TO, REQUEST YOUR AGENT AND
2 SUCCESSOR AGENTS TO PROVIDE SPECIMEN SIGNATURES BELOW. IF
3 YOU INCLUDE SPECIMEN SIGNATURES IN THIS POWER OF ATTORNEY,
4 YOU MUST COMPLETE THE CERTIFICATION OPPOSITE THE SIGNATURES
5 OF THE AGENTS.)
6 Specimen signatures of I certify that the signatures of my
7 agent (and successors). agent (and successors) are correct.
8 .......................... .................................
9 (agent) (principal)
10 .......................... .................................
11 (successor agent) (principal)
12 .......................... .................................
13 (successor agent) (principal)"
14 (b) The statutory short form power of attorney for
15 health care (the "statutory health care power") authorizes
16 the agent to make any and all health care decisions on behalf
17 of the principal which the principal could make if present
18 and under no disability, subject to any limitations on the
19 granted powers that appear on the face of the form, to be
20 exercised in such manner as the agent deems consistent with
21 the intent and desires of the principal. The agent will be
22 under no duty to exercise granted powers or to assume control
23 of or responsibility for the principal's health care; but
24 when granted powers are exercised, the agent will be required
25 to use due care to act for the benefit of the principal in
26 accordance with the terms of the statutory health care power
27 and will be liable for negligent exercise. The agent may
28 act in person or through others reasonably employed by the
29 agent for that purpose but may not delegate authority to make
30 health care decisions. The agent may sign and deliver all
31 instruments, negotiate and enter into all agreements and do
32 all other acts reasonably necessary to implement the exercise
33 of the powers granted to the agent. Without limiting the
34 generality of the foregoing, the statutory health care power
-8- LRB9011434DJksam01
1 shall include the following powers, subject to any
2 limitations appearing on the face of the form:
3 (1) The agent is authorized to give consent to and
4 authorize or refuse, or to withhold or withdraw consent to,
5 any and all types of medical care, treatment or procedures
6 relating to the physical or mental health of the principal,
7 including any medication program, surgical procedures,
8 life-sustaining treatment or provision of food and fluids for
9 the principal.
10 (2) The agent is authorized to admit the principal to or
11 discharge the principal from any and all types of hospitals,
12 institutions, homes, residential or nursing facilities,
13 treatment centers and other health care institutions
14 providing personal care or treatment for any type of physical
15 or mental condition. The agent shall have the same right to
16 visit the principal in the hospital or other institution as
17 is granted to a spouse or adult child of the principal, any
18 rule of the institution to the contrary notwithstanding.
19 (3) The agent is authorized to contract for any and all
20 types of health care services and facilities in the name of
21 and on behalf of the principal and to bind the principal to
22 pay for all such services and facilities, and to have and
23 exercise those powers over the principal's property as are
24 authorized under the statutory property power, to the extent
25 the agent deems necessary to pay health care costs; and the
26 agent shall not be personally liable for any services or care
27 contracted for on behalf of the principal.
28 (4) At the principal's expense and subject to reasonable
29 rules of the health care provider to prevent disruption of
30 the principal's health care, the agent shall have the same
31 right the principal has to examine and copy and consent to
32 disclosure of all the principal's medical records that the
33 agent deems relevant to the exercise of the agent's powers,
34 whether the records relate to mental health or any other
-9- LRB9011434DJksam01
1 medical condition and whether they are in the possession of
2 or maintained by any physician, psychiatrist, psychologist,
3 therapist, hospital, nursing home or other health care
4 provider.
5 (5) The agent is authorized: to direct that an autopsy
6 be made pursuant to Section 2 of "An Act in relation to
7 autopsy of dead bodies", approved August 13, 1965, including
8 all amendments; if authorized on the face of the form, to
9 make a disposition of any part or all of the principal's body
10 pursuant to the Uniform Anatomical Gift Act, as now or
11 hereafter amended; and to direct the disposition of the
12 principal's remains.
13 (Source: P.A. 86-736.)".