Healthcare POA Form Could Put Donation Desires at Risk
Gift of Hope is encouraging its donor hospitals to revisit the intent of the State of Illinois’ healthcare power of attorney (POA) short form to better understand how it can impact donation. Depending on if, when and how the POA is completed, a person may unknowingly put his or her desire to be an organ and tissue donor at risk.
The form in question is the Statutory Short Form Power of Attorney (POA) for Health Care, a revised version of which was made available by the State of Illinois in July. Many hospitals distribute this generic POA form as part of their admissions packets or on nursing units to offer patients the opportunity to ensure that “advance directives” are in place to govern critical decision-making should they be unable to make healthcare decisions for themselves.
By properly signing, dating and notarizing the POA form, a person—the principal—grants someone else—his or her designated agent—broad powers to make healthcare decisions on the principal’s behalf should the principal be unable to do so for himself or herself. One of those decisions is whether to make an anatomical gift for transplantation or research.
That’s where potential problems can arise, according to Kathy Vasilopulos, RN, Director of Hospital Development for Gift of Hope. “Hospital staff members must fully understand the impact a POA can have on a person’s previous decision to be a donor,” she explained. “The POA is a legal document. If it is properly completed after a person has registered as a donor and initialed to shift the decision-making for being a donor to an agent, the POA is the legal document in force. In this situation, all other legally binding decisions made before it are rescinded, and the agent is then empowered to make donation decisions on the principal’s behalf should the principal become incapacitated. That means a principal’s donation decision registered in the Illinois Organ/Tissue Donor Registry becomes moot.”
A second potential problem arises if the principal does not authorize the agent to make anatomical gifts—one check-off option in the POA form. “It’s important to understand that initialing there does not constitute a decision to not be a donor,” Vasilopulos added. “This selection merely indicates the principal does not grant decision-making power about being a donor to the agent named in the POA. The opportunity for donation still exists, either through the principal’s previous designation in the Illinois Registry or, absent that, through authorization by the person with legal authority to make the decision.”
Hospital staff can take two steps to avoid these problems, Vasilopulos advised. First, they must have a clear understanding of the POA’s intent and the potential ramifications of having a patient sign and initial a POA if he or she has previously registered in the Illinois Organ/Tissue Donor Registry. Second, they must explain these ramifications to patients and family members when they distribute these documents to patients.
“When distributing the POA to a patient, ask if he or she is a registered organ and tissue donor,” Vasilopulos advised. “If so, explain that giving an agent the power to decide whether to make anatomical gifts via the POA could affect their previous decision to be a donor. More than likely, the agent will be on board with the principal’s previous donation decision and will ensure that it is honored. But the POA grants the agent the legal right to go against an individual’s wishes.”
Hospitals are encouraged to download a copy of the POA short form and talk with their Gift of Hope representatives if they have any questions about the form and its intent with regard to donation, Vasilopulos said.
