Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VIII - Intellectual Disability and Autism Manual › Subpart A - Statements of Policy › Chapter 6000 - STATEMENTS OF POLICY › Subchapter R - PROCEDURES FOR SURROGATE HEALTH CARE DECISION MAKING › HEALTH CARE DECISION MAKING › Section 6000.1016 - Limitations on authority of the surrogate health care decision maker

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A surrogate
						health care decision maker may not execute an advance health care directive or
						name a health care agent on behalf of an incompetent individual.
(b) Under 20 Pa.C.S. Chapter 54 (relating to
						health care) and applicable case law (see
In re D.L.H,
2 A.2d.
						505 (Pa. 2010)), neither a health care representative nor a guardian nor a
						facility director has authority to refuse life-preserving care for a person who
						has a life-threatening medical condition, but is neither in an end-stage
						medical condition nor permanently unconscious.
(c) Title
						20 Pa.C.S. §
													5462(c)(1) (relating to
						duties of attending physician and health care provider) provides:
"Health care necessary to preserve life shall be
						  provided to an individual who has neither an end-stage medical condition nor is
						  permanently unconscious, except if the individual is competent and objects to
						  such care or a health care agent objects on behalf of the principal if
						  authorized to do so by the health care power of attorney or living will."
(d) A residential facility
						as defined by Act 28 must provide necessary treatment, care, goods or services
						to an individual except where otherwise permitted under
						18 Pa.C.S. §
													2713(e) (relating to neglect
						of care-dependent person) as follows:
(1) The
						caretaker's, individual's, or facility's lawful compliance with a
						care-dependent person's living will as provided in 20 Pa.C.S. Chapter
						54.
(2) The caretaker's,
						individual's, or facility's lawful compliance with a care-dependent person's
						written, signed, and witnessed instructions, executed when the care-dependent
						person is competent as to the treatment he wishes to receive.
(3) The caretaker's, individual's or
						facility's lawful compliance with the direction of one of the following:
(i) An agent acting under a lawful durable
						power of attorney under 20 Pa.C.S. Chapter 56 (relating to powers of attorney),
						within the scope of that power.
(ii) A health care agent acting under a
						health care power of attorney under 20 Pa.C.S. Chapter 54, Subchapter C
						(relating to health care agents and representatives), within the scope of that
						power.
(4) The
						caretaker's, individual's, or facility's lawful compliance with a DNR order
						written and signed by the care-dependent person's attending physician.
						Generally, a DNR order is appropriate in the presence of an end-stage medical
						condition.
(5) The caretaker's,
						individual's, or facility's lawful compliance with the direction of a
						care-dependent person's health care representative under
						20 Pa.C.S. §
														5461
						(relating to decisions by health care representative), provided the care
						dependent person has an end-stage medical condition or is permanently
						unconscious as these terms are defined in
						20 Pa.C.S. §
														5422
						(relating to definitions) as determined and documented in the person's medical
						record by the person's attending physician.