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Decisions by health care representative - 20 Pa. Cons. Stat. § 5461

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     § 5461.  Decisions by health care representative.
        (a)  General rule.--A health care representative may make a
     health care decision for an individual whose attending physician
     has determined that the individual is incompetent if:
            (1)  the individual is at least 18 years of age, has
        graduated from high school, has married or is an emancipated
        minor;
            (2)  (i)  the individual does not have a health care
            power of attorney; or
                (ii)  the individual's health care agent is not
            reasonably available or has indicated an unwillingness to
            act and no alternate health care agent is reasonably
            available; and
            (3)  a guardian of the person to make health care
        decisions has not been appointed for the individual.
        (b)  Application.--This section applies to decisions
     regarding treatment, care, goods or services that a caretaker is
     obligated to provide to a care-dependent person who has an end-
     stage medical condition or is permanently unconscious as
     permitted under 18 Pa.C.S. § 2713(e)(5) (relating to neglect of
     care-dependent person).
        (c)  Extent of authority of health care representative.--
     Except as set forth in section 5462(c)(1) (relating to duties of
     attending physician and health care provider), the authority and
     the decision-making process of a health care representative
     shall be the same as provided for a health care agent in section
     5456 (relating to authority of health care agent) and 5460(c)
     (relating to relation of health care agent to court-appointed
     guardian and other agents).
        (d)  Who may act as health care representative.--
            (1)  An individual of sound mind may, by a signed writing
        or by personally informing the attending physician or the
        health care provider, designate one or more individuals to
        act as health care representative. In the absence of a
        designation or if no designee is reasonably available, any
        member of the following classes, in descending order of
        priority, who is reasonably available may act as health care
        representative:
                (i)  The spouse, unless an action for divorce is
            pending, and the adult children of the principal who are
            not the children of the spouse.
                (ii)  An adult child.
                (iii)  A parent.
                (iv)  An adult brother or sister.
                (v)  An adult grandchild.
                (vi)  An adult who has knowledge of the principal's
            preferences and values, including, but not limited to,
            religious and moral beliefs, to assess how the principal
            would make health care decisions.
            (2)  An individual may by signed writing, including a
        health care power of attorney, provide for a different order
        of priority.
            (3)  An individual with a higher priority who is willing
        to act as a health care representative may assume the
        authority to act notwithstanding the fact that another
        individual has previously assumed that authority.
        (e)  Disqualification.--An individual of sound mind may
     disqualify one or more individuals from acting as health care
     representative in the same manner as specified under subsection
     (d) for the designation of a health care representative. An
     individual may also disqualify one or more individuals from
     acting as health care representative by a health care power of
     attorney. Upon the petition of any member of the classes set
     forth in subsection (d), the court may disqualify for cause
     shown an individual otherwise eligible to serve as a health care
     representative.
        (f)  Limitation on designation of health care
     representative.--Unless related by blood, marriage or adoption,
     a health care representative may not be the principal's
     attending physician or other health care provider nor an owner,
     operator or employee of a health care provider in which the
     principal receives care.
        (g)  Decision of health care representative.--
            (1)  If more than one member of a class assumes authority
        to act as a health care representative, the members do not
        agree on a health care decision and the attending physician
        or health care provider is so informed, the attending
        physician or health care provider may rely on the decision of
        a majority of the members of that class who have communicated
        their views to the attending physician or health care
        provider.
            (2)  If the members of the class of health care
        representatives are evenly divided concerning the health care
        decision and the attending physician or health care provider
        is so informed, an individual having a lower priority may not
        act as a health care representative. So long as the class
        remains evenly divided, no decision shall be deemed made
        until such time as the parties resolve their disagreement.
        Notwithstanding such disagreement, nothing in this subsection
        shall be construed to preclude the administration of health
        care treatment in accordance with accepted standards of
        medical practice.
        (h)  Duty of health care representative.--Promptly upon
     assuming authority to act, a health care representative shall
     communicate the assumption of authority to the members of the
     principal's family specified in subsection (d) who can be
     readily contacted.
        (i)  Countermand of health care decision.--
            (1)  A principal of sound mind may countermand any health
        care decision made by the principal's health care
        representative at any time and in any manner by personally
        informing the attending physician or health care provider.
            (2)  Regardless of the principal's mental or physical
        capacity, a principal may countermand a health care decision
        made by the principal's health care representative that would
        withhold or withdraw life-sustaining treatment at any time
        and in any manner by personally informing the attending
        physician.
            (3)  The attending physician or health care provider
        shall make reasonable efforts to promptly inform the health
        care representative of a countermand exercised under this
        section.
            (4)  A countermand exercised under this section shall not
        affect the authority of the health care representative to
        make other health care decisions.
        (j)  Court approval unnecessary.--A health care decision made
     by a health care representative for a principal shall be
     effective without court approval.
        (k)  Written declaration of health care representative.--An
     attending physician or health care provider may require a person
     claiming the right to act as health care representative for a
     principal to provide a written declaration made under penalty of
     perjury stating facts and circumstances reasonably sufficient to
     establish the claimed authority.

        Cross References.  Section 5461 is referred to in sections
     5422, 5431, 5453 of this title; section 2713 of Title 18 (Crimes
     and Offenses).

Last modified: November 27, 2007