Advance Medical Directives , Ministry of Health
Services

Advance Medical Directives

Service Description

Living will – providing Advance Medical Directives and appointing a power of attorney


The Terminally Ill Patient Law deals with terminally ill patients who are sick with an incurable disease at the end of their days. Terminally ill patient is defined by the law as a patient who is sick with an incurable disease and whose life expectancy does not exceed six months, even if receiving medical care. 

 

The law requires the medical staff to provide palliative care to a terminally ill patient and to their families. The law also regulates the rules whereby a person may direct in advance not to receive medical care if they are terminally ill and incompetent to make lucid decisions, in order to avoid prolonged suffering. The law states the conditions and restrictions to avoid medical care and prohibits actively causing death or assisting in suicide. Any person from the age of 17 who is competent to make decisions, whether ill or healthy, is allowed to provide advance medical directives and/or to appoint a power of attorney. They may provide advance medical directives, appoint a power of attorney or both, as they choose. 

 

As long as a person is lucid and fully conscious, their wishes take precedence!  Advance medical directives or power of attorney appointment will take effect only if the patient becomes incompetent to make decisions. 


Types of Advance Medical Directives and Power of Attorney Appointment


Advanced Directives as to Future Medical Care Of a Dying Patient (Appendix 1) 

This form is intended to be filled in by a person who wishes to provide advance medical directives, in which they detail their wishes concerning future medical care, if they become terminally ill and incompetent (such as due to lack of consciousness), to avoid medical treatments or to receive any extraordinary life-extending medical treatment. 
 
The person providing advance medical directives will detail in the form which treatments they wishes to avoid  and which they wish to receive, after having received an explanation from a physician or a registered nurse concerning the medical terms contained in this medical directives form, so that they may sign them based on an informed decision. For example, a person may direct in advance to terminate periodical medical treatments such as dialyses, chemotherapy and irradiations, if these treatments are related to their incurable disease.
 
Advance medical directives are valid for five years. They may be extended every five years or cancelled at any time. The instructions may also be updated at any time by re-filling out the form. 

Power of Attorney for Issuing Directives as to the Medical Care of a Terminally-Ill Patient (Appendix 2)

This form is intended to be filled in by a person who wishes to grant their power of attorney to a Surrogate that will be qualified to decide in their place on medical treatment to be provided (or not provided), if they become terminally ill and incompetent. 
 
The form allows the appointer to grant powers of attorney to another person, a Surrogacy, whom they trusts, to speak on their behalf when they are unable to express their wishes. The person acting as power of attorney may express the patient’s wishes and decisions concerning receipt of or abstention from medical treatments. Power of attorney appointment prevents differences of opinions between family members and the attending staff and prevents the need to appoint a guardian for the patient’s body. Power of attorney appointment applies only to medical conditions and does not apply to pecuniary affairs.
 
The form has a number of options to be selected by the appointer (page 4), granting the power of attorney various degrees of power:
  • Option A – the power of attorney may receive any decision concerning treatment or non-treatment for the appointer, as detailed in the form. Selection of this option exempts the person providing the instruction from the need to receive an explanation of medical terms from a physician / registered nurse.
  • Option B – the power of attorney is limited only to consent to receive life-extending treatment.
  • Option C – allows for choosing which specific treatments to abstain or not abstain from giving.
Power of attorney appointment is valid for five years. It may be extended every five years or cancelled at any time. The appointment may also be updated at any time by filling the form again. 


Combined power of attorney appointment in accordance with the Patient’s Rights Law and the Terminally Ill Patient Law (Appendix 3)
Combined power of attorney appointment form is intended to be filled in by a person who wishes to appoint a power of attorney for Issuing Directives as to the Medical Care of a Terminally-Ill Patient to represent them both under the Patient’s Rights Law and under the Terminally Ill Patient Law (as described above). Combined power of attorney appointment applies only to medical conditions and does not apply to pecuniary affairs. Combined power of attorney appointment allows the power of attorney to make medical decisions both on abstention from life-extending medical treatment if the patient becomes terminally ill, and for other medical conditions.
 
Combined power of attorney appointment is a general appointment (Option A of power of attorney appointment pursuant to the Terminally Ill Patient Law) and therefore does not require the person providing instructions to receive explanations of medical terms from a physician or registered nurse.
Power of attorney appointment is valid for five years. It may be extended every five years or cancelled at any time. The appointment may also be updated at any time by filling the form again. 


Instructions to Extend the Validity of Advanced Medical Directives or Surrogacy Appointment (Appendix 3) 

This form is intended to be filled in by a person who wishes to extend the validity of Advanced Medical Directives and/or Surrogacy Appointment and/or a Combined Power of Appointment. Its validity may be extended every five years using an abridged form.

Expressing the wishes of terminally ill competent patient who does not wish to continue to live (Regulation 14A)

This form is intended to be filled in by a person who wishes to back a personal statement in real time, that they are not interested in life-extending treatment. Since this is a real time directive, the form is filled in at the hospital and not in advance.

Depositing forms at the Central Data Bank of Advance Medical Directives


Advance medical directives and/or power of attorney appointments pursuant to the Terminally Ill Patient Law that are properly filled oblige the medical staff. Therefore it is advisable to send the completed forms for depositing at the repository of the Central Data Bank of Advance Medical Directives at the Ministry of Health, so that the Data Bank's staff can check them for validity, send the form filler confirmation of their validity and input into the repository. In addition, the depositor of the forms will be sent a card that they can keep in their wallet. 
  
 
 Before the expiration of the advance medical instructions / power of attorney appointment deposited in the Ministry of Health’s repository, a reminder will be sent to the depositor. Forms that are deposited in the Ministry of Health repository will be accessible through the computer system to caregivers at hospitals.


Service Details

Reception Area


The forms are to be sent by registered mail with a photocopy of the applicant’s identity card to:

The Ministry of Health

The Central Data Bank of Advance Medical Directives

39 Yirmiyahu St., Jerusalem 9101002

P.O.Box 1176 


Contact through Voice of Health center:

Phone: *5400, 08-6241010

Fax:  02-5655969 

Email: call.habriut@moh.health.gov.il

לחץ לגרסת הדפסהPrint version
  
  
  
  

This information is also available in the following languages:

עבריתعربيFrançaisРусский

Cancellation of the combined power of attorney form

 

Due to an amendment to the Legal Competence Law, as of April 11, 2007, it is not possible to deposit forms of a combined power of attorney, but only a power of attorney to provide medical instructions for medical treatment of a dying patient and preliminary medical guidelines for future medical treatment in a patient who is dying.

All forms signed prior to this date shall be deposited on the website of the Ministry of Health and shall be admissible by law, and shall be valid until the expiry date (5 years from the approval date).

Any future renewal or extension of the validity of existing guidelines shall be in accordance with the provisions of the Dying Patient Law (notice will be sent on the renewal date).