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Connecticut Documento estatutario sobre el nombramiento de un...

Documento Legal Concerniente a la Designación de Representante de Atención Médica - Connecticut Statutory Document Concerning the Appointment of Health Care Representative

State:

Connecticut

Category:

Poder notarial - Cuidado de la salud - Testamentos en vida - Alaska

Control #:

CT-P016A

Format:

57 downloads

Description

This is a statutory health care power of attorney, provided for in Connecticut statutes, appointing a person to make healthcare decisions to you when you are unable. It is used when you have a living will or your health care wishes are known to the representative. An alternate representative may also be named. Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.

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How to fill out Connecticut Documento Estatutario Sobre El Nombramiento De Un Representante De Atención Médica?

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Power of Attorney and Living Will / Health Care Directive

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Documento estatutario sobre el nombramiento de un representante de atención médica

ALL REFERENCES ARE TO THE GENERAL STATUTES OF CONNECTICUT

REMOVAL OF LIFE SUPPORT SYSTEMS
(Including Appointment of Health Care Agent)
(§§ 19a-570 through 19a-580c)

A "life support system" is any medical procedure or intervention which, when applied to an individual, would serve only to postpone the moment of death or maintain the individual in a state of permanent unconsciousness. In these circumstances, such procedures include, but are not limited to, mechanical or electronic devices including artificial means of providing nutrition or hydration.

A "terminal condition" is the final stage of an incurable or irreversible medical condition which, without the administration of a life support system, will result in death within a relatively short time, in the opinion of the attending physician.

"Permanently unconscious" is a when a person is in a permanent coma and persistent vegetative state and is an irreversible condition in which the individual is at no time aware of himself or the environment and shows no behavioral response to the environment.

A "health care agent" means an adult person to whom authority to convey health care decisions is delegated in a written document by another adult person, known as the principal.

"Incapacitated" is being unable to understand and appreciate the nature and consequences of health care decisions, including the benefits and disadvantages of such treatment, and to reach and communicate an informed decision regarding the treatment.

A "living will" is a written statement in compliance with section 19a-575a containing a declarant's wishes concerning any aspect of his health care, including the withholding or withdrawal of life support systems.

The provisions of §§ 19a-571 to 19a-573, inclusive, 19a-575 and 19a-575a do not apply to a pregnant patient.

Any person eighteen years of age or older may execute a document which contains directions as to specific life support systems which that person chooses to have administered. The document must be signed and dated by the maker with at least two witnesses. The statutory form is not mandatory.

Any person eighteen years of age or older may execute a document which contains health care instructions, the appointment of a health care agent, the appointment of an attorney-in-fact for health care decisions, the designation of a conservator of the person for future incapacity and a document of anatomical gift. Such a document must be signed and dated by the maker with at least two witnesses. The statutory form is not mandatory.

Any person eighteen years of age or older may appoint a health care agent by executing a document in accordance with §19a-575a or §19a-577, signed and dated by that person in the presence of two adult witnesses who must also sign the document. The person appointed as agent cannot act as witness to the execution of the document or sign the document.

For persons who reside in facilities operated or licensed by the Department of Mental Health and Addiction Services, at least one witness must be an individual who is not affiliated with the facility and at least one witness must be a physician or clinical psychologist with specialized training in treating mental illness.

For persons who reside in facilities operated or licensed by the Department of Mental Retardation, at least one witness must be an individual who is not affiliated with the facility and at least one witness must be a physician or clinical psychologist with specialized training in developmental disabilities.

An operator, administrator, or employee of a hospital, residential care home, rest home with nursing supervision, or chronic and convalescent nursing home may not be appointed as a health care agent by any person who, at the time of the appointment, is a patient or a resident of, or has applied for admission to, one of the foregoing facilities. An administrator or employee of a government agency which is financially responsible for a person's medical care may not be appointed as a health care agent for such person. This restriction does apply if such operator, administrator or employee is related to the principal by blood, marriage or adoption.

A physician may not act as both agent for a principal and attending physician for the principal.

The statutory form is not mandatory.

A living will or appointment of health care agent becomes operative when the document is furnished to the attending physician and the declarant is determined by the attending physician to be incapacitated.

A living will or appointment of health care agent may be revoked at any time and in any manner by the declarant without regard to the declarant's mental or physical condition. Unless the principal specifies otherwise, the appointment of the principal's spouse as health care agent is revoked upon the divorce or legal separation of the principal and spouse or upon the annulment or dissolution of their marriage.

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Documento estatutario sobre el nombramiento de un representante de atención médica

ALL REFERENCES ARE TO THE GENERAL STATUTES OF CONNECTICUT

REMOVAL OF LIFE SUPPORT SYSTEMS
(Including Appointment of Health Care Agent)
(§§ 19a-570 through 19a-580c)

A "health care agent" means an adult person to whom authority to convey health care decisions is delegated in a written document by another adult person, known as the principal.

The provisions of §§ 19a-571 to 19a-573, inclusive, 19a-575 and 19a-575a do not apply to a pregnant patient.

A physician may not act as both agent for a principal and attending physician for the principal.

The statutory form is not mandatory.

Note: All Information and Previews are subject to the Disclaimer located on the main forms page, and also linked at the bottom of all search results.

Documento Legal Concerniente a la Designación de Representante de Atención Médica - Connecticut Statutory Document Concerning the Appointment of Health Care Representative

Description

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How to fill out Connecticut Documento Estatutario Sobre El Nombramiento De Un Representante De Atención Médica?

Power of Attorney and Living Will / Health Care Directive

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Documento Legal Concerniente a la Designación de Representante de Atención Médica - Connecticut Statutory Document Concerning the Appointment of Health Care Representative

Description

Related forms

Get your form ready online

Looking for another form?

Viewed forms

How to fill out Connecticut Documento Estatutario Sobre El Nombramiento De Un Representante De Atención Médica?

Power of Attorney and Living Will / Health Care Directive

Form popularity

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