How Your Medical Practice Can Navigate Power of Attorney

Across the US, healthcare providers must follow a patient’s power of attorney to the best of their abilities. This is paramount for making sure they get the care they need, and want, in a crisis. In this article, we look closely at how your practice can approach medical power of attorney.

Helping Patients Set Up a POA

If a patient is unconscious and you don’t know the treatments they consent to, this can lead to a major (possibly life-threatening) deadlock. You can avoid this by helping them create their power of attorney. This clarifies the patient’s preferences and allows somebody else to make decisions for them.

Many websites offer comprehensive state-specific POA templates which can satisfy every legal requirement. For example, a New Jersey medical power of attorney will need the signature of a notary public. Generally speaking, healthcare providers or employees cannot legally serve as a patient’s agent or witness.

Since these forms effectively dictate a person’s treatment plan, your patients may ask you about them — including how to fill them out. As a result, it’s your responsibility to learn as much as you can about these arrangements. This lets patients gain a better understanding of their healthcare rights.

Balancing Your Oath

Every doctor has a responsibility to help their patients under the American Medical Association’s Code of Medical Ethics. However, power of attorney is as much about withholding treatments as it is allowing them. If someone refuses treatment via their document (or appointed agent), health professionals have to respect this.

This is why healthcare professionals cannot serve as an agent for one of their patients. Not only would it be an inappropriate dynamic, but it can also violate their ethical responsibility to provide care. However, doctors can administer life-saving emergency treatment in most situations where a patient hasn’t forbidden it.

Patients on end-of-life care (and life support) might refuse certain treatments in their POA, either directly or via their agent. Doctors and other medical staff have to abide by this at all times. They can still inform the patient’s representative about the available options, but agents have the final say regardless.

On the other hand, agents might advocate for ‘futile medical care’. For example, when acting on behalf of a patient with late-stage cancer, they might request aggressive chemotherapy — even when it likely wouldn’t help. If the team’s explanations cannot convince the agent, you may have to consult your ethics committee.

Which Treatments Are Allowed?

Even in a situation involving medical power of attorney, doctors and other staff members can still take action to save their patients. These arrangements typically limit themselves to planned and ongoing treatments. They still take effect in emergency medical situations, but there usually isn’t time to consult them.

The patient can include a DNR (do not resuscitate) order in their document if they so desire. On top of this, they can say if they object to certain life-saving interventions, such as ventilators. An agent generally cannot refuse emergency treatments — unless the patient explicitly says this in their document.

Experimental treatments on an incapacitated patient may be controversial. If an agent or a POA form approves it, however, the staff can go ahead. Though the procedures are incredibly helpful, they often come with side effects. There is thus another barrier of approval before staff can start these treatments.

Storing and Verifying a Power of Attorney Form

You and your staff need to quickly check if the power of attorney is valid. This can involve asking the agent for their government ID and checking it against the form. Many practices ask patients to give them a copy of their POA to avoid the possibility of foul play in a crisis. They could then simply check the agent’s identity against a document that’s already safely in their possession.

On a similar note, practices must store POA documents securely. This could be through a digital solution, such as cloud storage with strong encryption. Electronic health records are accessible at a moment’s notice, including in an emergency. Physical forms will have to stay in secure filing cabinets until you need them. In fact, a physical backup can help in case the EHRs are down.

The Health Insurance Portability and Accountability Act means all electronic medical data has to stay secure. As a result, only certain staff members will be able to access the electronic POA on short notice. Your practice also requires a strong backup system in case of a serious tech failure. This must go beyond simply keeping physical copies, just to be safe.

Final Thoughts

How your practice integrates POA forms will have a massive impact on patient care. Consider a digital-first approach which combines robust storage with online templates. This will cut down on problems of all kinds, while keeping your patient’s autonomy intact in every way that matters.