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Requirements and options - 20 Pa. Cons. Stat. § 5453

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     § 5453.  Requirements and options.
        (a)  General rule.--A health care power of attorney shall:
            (1)  Identify the principal and appoint the health care
        agent.
            (2)  Declare that the principal authorizes the health
        care agent to make health care decisions on behalf of the
        principal.
        (b)  Optional provisions.--A health care power of attorney
     may, but need not:
            (1)  Describe any limitations that the principal imposes
        upon the authority of the health care agent.
            (2)  Indicate the intent of the principal regarding the
        initiation, continuation, withholding or withdrawal of life-
        sustaining treatment.
            (3)  Indicate whether the principal wants tube feeding or
        any other artificial or invasive form of nutrition or
        hydration.
            (4)  Disqualify an individual from acting as a health
        care representative, prohibit the appointment of a health
        care representative or provide for an order of priority of
        appointment of a health care representative pursuant to
        section 5461(d) (relating to decisions by health care
        representative).
            (5)  Nominate a guardian of the person of the principal
        as provided in section 5460 (relating to relation of health
        care agent to court-appointed guardian and other agents).
            (6)  Contain other provisions as the principal may
        specify regarding the implementation of health care decisions
        and related actions by the health care agent or health care
        representative.
            (7)  Request that the health care agent or health care
        representative exercise his sole and absolute discretion to
        consult the principal's relative, cleric or physician should
        the health care agent or health care representative be
        uncertain of the principal's wishes or best interests.

Last modified: November 27, 2007