2010 Pennsylvania Code
Title 20 - DECEDENTS, ESTATES AND FIDUCIARIES
Chapter 54 - Health Care
5456 - Authority of health care agent.

     § 5456.  Authority of health care agent.
        (a)  Extent of authority.--Except as expressly provided
     otherwise in a health care power of attorney and subject to
     subsection (b) and section 5460 (relating to relation of health
     care agent to court-appointed guardian and other agents), a
     health care agent shall have the authority to make any health
     care decision and to exercise any right and power regarding the
     principal's care, custody and health care treatment that the
     principal could have made and exercised. The health care agent's
     authority may extend beyond the principal's death to make
     anatomical gifts, dispose of the remains and consent to
     autopsies.
        (b)  Life-sustaining treatment decisions.--A life-sustaining
     treatment decision made by a health care agent is subject to
     this section and sections 5429 (relating to pregnancy), 5454
     (relating to when health care power of attorney operative) and
     5462(a) (relating to duties of attending physician and health
     care provider).
        (c)  Health care decisions.--
            (1)  The health care agent shall gather information on
        the principal's prognosis and acceptable medical alternatives
        regarding diagnosis, treatments and supportive care.
            (2)  In the case of procedures for which informed consent
        is required under section 504 of the act of March 20, 2002
        (P.L.154, No.13), known as the Medical Care Availability and
        Reduction of Error (Mcare) Act, the information shall include
        the information required to be disclosed under that act.
            (3)  In the case of health care decisions regarding end
        of life of a patient with an end-stage medical condition, the
        information shall distinguish between curative alternatives,
        palliative alternatives and alternatives which will merely
        serve to prolong the process of dying. The information shall
        also distinguish between the principal's end-stage medical
        condition and any other concurrent disease, illness or
        physical, mental, cognitive or intellectual condition that
        predated the principal's end-stage medical condition.
            (4)  After consultation with health care providers and
        consideration of the information obtained in accordance with
        paragraphs (1), (2) and (3), the health care agent shall make
        health care decisions in accordance with the health care
        agent's understanding and interpretation of the instructions
        given by the principal at a time when the principal had the
        capacity to understand, make and communicate health care
        decisions. Instructions include an advance health care
        directive made by the principal and any clear written or
        verbal directions that cover the situation presented.
            (5)  (i)  In the absence of instruction, the health care
            agent shall make health care decisions that conform to
            the health care agent's assessment of the principal's
            preferences and values, including religious and moral
            beliefs.
                (ii)  If the health care agent does not know enough
            about the principal's instructions, preferences and
            values to decide accordingly, the health care agent shall
            take into account what the agent knows of the principal's
            instructions, preferences and values, including religious
            and moral beliefs, and the health care agent's assessment
            of the principal's best interests, taking into
            consideration the following goals and considerations:
                    (A)  The preservation of life.
                    (B)  The relief from suffering.
                    (C)  The preservation or restoration of
                functioning, taking into account any concurrent
                disease, illness or physical, mental, cognitive or
                intellectual condition that may have predated the
                principal's end-stage medical condition.
                (iii)  (A)  In the absence of a specific, written
                authorization or direction by a principal to withhold
                or withdraw nutrition and hydration administered by
                gastric tube or intravenously or by other artificial
                or invasive means, a health care agent shall presume
                that the principal would not want nutrition and
                hydration withheld or withdrawn.
                    (B)  The presumption may be overcome by
                previously clearly expressed wishes of the principal
                to the contrary. In the absence of such clearly
                expressed wishes, the presumption may be overcome if
                the health care agent considers the values and
                preferences of the principal and assesses the factors
                set forth in subparagraphs (i) and (ii) and
                determines it is clear that the principal would not
                wish for artificial nutrition and hydration to be
                initiated or continued.
            (6)  The Department of Health shall ensure as part of the
        licensure process that health care providers under its
        jurisdiction have policies and procedures in place to
        implement this subsection.
        (d)  Health care information.--
            (1)  Unless specifically provided otherwise in a health
        care power of attorney, a health care agent has the same
        rights and limitations as the principal to request, examine,
        copy and consent or refuse to consent to the disclosure of
        medical or other health care information.
            (2)  Disclosure of medical or other health care
        information to a health care agent does not constitute a
        waiver of any evidentiary privilege or of a right to assert
        confidentiality. A health care provider that discloses such
        information to a health care agent in good faith shall not be
        liable for the disclosure. A health care agent may not
        disclose health care information regarding the principal
        except as is reasonably necessary to perform the agent's
        obligations to the principal or as otherwise required by law.

        Cross References.  Section 5456 is referred to in sections
     5431, 5463 of this title.