Power of Attorney for Medical Decisions

DURABLE POWER OF ATTORNEY FOR MEDICAL DECISIONS

This Power of Attorney is made on poa_date

I, principal_name, son/daughter of principal_father, aged about principal_age years, resident of principal_address, CNIC No. principal_cnic, being of sound mind, do hereby appoint agent_name, son/daughter of agent_father, resident of agent_address, CNIC No. agent_cnic, as my Healthcare Agent to make medical decisions on my behalf in the event I am unable to do so.

AUTHORITY AND DIRECTIONS

1. ACTIVATION: This Power of Attorney shall come into effect upon my incapacity (whether due to unconsciousness, terminal illness, or mental impairment) certified by two qualified medical practitioners, and shall remain effective for so long as the incapacity continues. It is a durable Power of Attorney that shall not be revoked by my subsequent incapacity.

2. SCOPE OF AUTHORITY: My Healthcare Agent shall have authority to (a) consent to or refuse any medical treatment, surgery, or procedure on my behalf; (b) access my medical records and communicate with healthcare providers; (c) admit me to or discharge me from any hospital or care facility; (d) consent to or refuse life-sustaining treatment, in accordance with my Living Will (if any) and my known values and preferences; (e) consent to organ donation in accordance with my preferences; (f) authorise pain management including palliative care; and (g) make decisions regarding nursing care, rehabilitation, and end-of-life arrangements.

3. PRIORITY OF LIVING WILL: If I have executed a Living Will or Advance Healthcare Directive, my Healthcare Agent shall give effect to the directives stated therein. The Healthcare Agent's authority is in furtherance of, and not in derogation of, any specific directives in such Living Will.

4. PRIORITY OVER OTHER DECISIONS: I direct that, while I am incapacitated, the decisions of my Healthcare Agent shall prevail over the views of any other person, including family members, save where such decisions would clearly contradict my known wishes or the directives in my Living Will.

5. ALTERNATE AGENT: If agent_name is unable, unwilling, or unavailable to act, I appoint alternate_agent_name, son/daughter of alternate_agent_father, CNIC No. alternate_agent_cnic, as my alternate Healthcare Agent.

6. RELIGIOUS AND CULTURAL CONSIDERATIONS: My Healthcare Agent shall make certain that all medical care provided to me is consistent with my religious faith of religion and my cultural values, including specific_directives.

7. DUTY TO ACT IN GOOD FAITH: My Healthcare Agent shall act in good faith in my best interests, taking into account my known values, preferences, and prior expressions of wishes. The Healthcare Agent shall consult with my treating physicians and, where appropriate, with my family, but the final decision-making authority rests with the Healthcare Agent.

8. ACCESS TO RECORDS AND PROCEEDINGS: My Healthcare Agent shall have full access to my medical records and may attend any medical consultation, hospital meeting, or care planning session on my behalf, in furtherance of his / her decision-making authority.

9. INSURANCE AND FINANCIAL MATTERS: My Healthcare Agent may also (a) communicate with my health insurance provider; (b) sign claim forms and provide necessary information; and (c) authorise payments to healthcare providers from my designated medical care fund or insurance, but shall not have general access to my other financial accounts.

10. NO LIABILITY: My Healthcare Agent shall not be liable for decisions made in good faith and in accordance with this Power of Attorney, save for gross negligence or wilful misconduct. I undertake to indemnify the Healthcare Agent against any loss arising from bona fide exercise of authority.

11. REVOCATION: I may revoke this Power of Attorney at any time while I retain mental capacity, by writing in similar form duly notarised. Revocation shall be communicated to my Healthcare Agent and to my treating physicians.

12. PRESENTATION TO HEALTHCARE PROVIDERS: My Healthcare Agent shall present a duly attested copy of this Power of Attorney to my treating physicians and any healthcare facility, who are hereby directed to give effect to it.

13. NOTARISATION: This Power of Attorney is signed in the presence of two witnesses and notarised by a Notary Public to ensure its authenticity and effect.

14. GOVERNING LAW: This Power of Attorney shall be governed by the Powers of Attorney Act 1882 and the laws of the Islamic Republic of Pakistan.

SIGNED BY THE PRINCIPAL: _____________________________ principal_name, CNIC: principal_cnic ACCEPTANCE BY HEALTHCARE AGENT: _____________________________ agent_name, CNIC: agent_cnic WITNESSES: 1. witness_1_name, CNIC: witness_1_cnic 2. witness_2_name, CNIC: witness_2_cnic NOTARY PUBLIC: _____________________________