Storing, Sharing, or Revoking Your Medical Power of Attorney

After you create your medical power of attorney and any other health care directives, make sure they are easy to find if needed. These documents only help if your health care agent, doctors, or family members can access them during an emergency. Give a copy of your medical power of attorney and related documents, such as a living will or advance directive, to your chosen agent. Keep the originals in a safe place that your loved ones can reach if necessary.

In addition to sharing copies, you might want to take extra steps to make your wishes known. Many states now have electronic registries where you can file your health care documents so medical providers can access them quickly. If you change your mind later, you can update or cancel your health care documents as long as you can make decisions. This article will show you how to store, share, and, if needed, revoke your medical power of attorney and other health care directives.

Before You Sign Your Medical Power of Attorney

Before you share your health care documents, you need to sign them in front of witnesses or a notary public, and sometimes both. The exact rules depend on your state and the type of documents you have. For more details on how to finalize your documents, including your state’s requirements, see Advance Directive Witness and Notary Requirements.

Making and Distributing Copies of your Medical POA

Once you have signed your medical power of attorney and other health care documents, share copies with the people who might need them. Start by giving a copy to your agent, your primary health care provider, and the medical facility where you are most likely to get treatment. You may also want to give copies to:

• any health care provider you see regularly
• the hospital or care facility where you would most likely be admitted
• your HMO or insurance plan’s patient representative
• close family members, such as your spouse, children, and siblings, and
• any trusted friends who might be involved in your care.

It’s common to feel uncomfortable talking about your treatment preferences; these are very personal topics. Still, your documents can only protect your wishes if the right people know about them. A medical directive won’t help if it is tucked away and no one can find it during an emergency.

Recording or Registering Your Health Care Directives

You aren’t legally required to record or register your health care directives anywhere. That said, if your state has an advance directive registry, you may want to put your documents on file. A growing number of states now maintain electronic registries where you can store your health care documents for quick access by medical professionals and your health care agent. While not required, these registries offer an additional layer of protection to ensure your wishes are available if needed.

Each state has its own process for registering health care documents. Many states charge a small fee to add your information to their database. Some states ask for a full copy of your advance directive, while others only need basic details, like your agent’s name and contact information, plus the location of the completed forms. After you register, most states issue a wallet card to carry and share so others know how to contact the registry in an emergency.

Keep in mind that medical facilities have been slow to adopt these registry systems, and many doctors and hospitals don't routinely check them when admitting patients. But registration is typically inexpensive and carries no downside. As awareness grows and medical professionals increasingly turn to these databases, having your documents on file could prove valuable. To find out if your state offers an advance directive registry, search online for your state's name plus "advance directive registry" or "living will registry."

Keeping Your Health Care Directives Up to Date

Don’t just file away your health care documents and forget about them. Review them every few years to make sure they still reflect your wishes. Medical technology changes, your health may change, and your preferences might shift over time. Some life events should also prompt you to update your documents:

• Your health care agent is no longer available, or you want to name a different person.
• You relocate to another state.
• You get married. Unless your new spouse is already named as your agent, prepare new documents after marriage. While you're never required to name your spouse as your agent, if you prefer to designate someone else, ensure you do so in a document dated after your marriage. Some states automatically revoke older documents naming a different agent when you marry.
• You get divorced or legally separate. Although most states automatically terminate your former spouse's authority as agent upon divorce, you should still create new documents to clearly establish your current wishes.
• Your documents are more than a few years old. State laws governing health care directives change over time, and older documents may no longer comply with current legal requirements.

Any new health care directive will automatically replace an old one, but you may want to take additional steps if you update your documents. The rest of this article discusses the best way to revoke your health care documents.

Revoking Your Medical Power of Attorney

You can revoke or cancel your medical power of attorney and other health care directives at any time, as long as you can make your own health care decisions. This means you can always update your documents to reflect your current wishes and situation.

The steps to revoke your health care agent’s appointment vary by state. In many places, you need to give written notice to your agent and health care providers or tell your primary doctor that you no longer want that person to serve. For other instructions in your directives, you can usually revoke them by telling your health care providers and anyone else who knows your wishes that you have changed your mind.

The Best Way to Revoke Your Medical Power of Attorney

If you are able, the best way to revoke a document is in writing. You should also tear up the original and ask anyone with a copy to return it so you can destroy it.

Even if you write a formal revocation, make sure to tell everyone who knows about your document that you have revoked it. If you registered your documents, remember to update or remove your information from the registry.

Does a New Medical POA Override an Old One?

When you have multiple health care documents with conflicting instructions, the most recent takes precedence. So why bother with a revocation form? Leaving older documents in circulation can create confusion, particularly if an older directive addresses issues your newer document doesn’t mention. To avoid this problem, make sure your previous documents are clearly revoked and destroyed. At the same time, make certain your new document is properly signed and witnessed, distributed to your health care agent and physician, and added to your medical records.

Can a Doctor Override Your Medical Power of Attorney?

A doctor can’t override or invalidate a health care power of attorney, but they may refuse to comply with your agent's decisions in some cases. For example, doctors might not follow your agent's directive if it:

• contradicts clear wishes in your living will or other advance directive
• goes against their professional conscience or hospital policy, or
• if they believe the requested treatment is not medically effective or doesn't comply with generally accepted medical standards.

If a doctor refuses to follow your agent’s instructions, the health care provider must tell the agent right away and may need to transfer care to another provider. Most doctors want to respect patients’ wishes. If your instructions are clear and you have named a health care agent who can explain your preferences, your choices should be followed. For orders that must be followed in all health care settings, consider a POLST form. Unlike advance directives, POLST orders are legally binding everywhere.

When Does a Medical Power of Attorney End?

A medical power of attorney ends in several situations. Most often, it terminates if the patient can make their own health care decisions again or dies. You can also end your agent’s authority by revoking it, as explained earlier.

A court can also end a medical power of attorney, but this rarely happens. Courts can override a medical POA if the agent is not acting in the patient’s best interests or can no longer serve. If you are unable to make decisions and your family suspects abuse or neglect, they can work with a lawyer to ask the court to step in and provide evidence for their concerns.

Family members, even spouses, cannot just override the agent named in a power of attorney. To challenge or end the agent’s authority, they must take the proper legal steps and ask a court to decide.

More Information About Advance Health Care Planning

If you take the time to complete, share, and keep your medical power of attorney up to date, your health care wishes are more likely to be respected if you cannot speak for yourself. By keeping your documents current, sharing them with the right people, and knowing when they can be changed or revoked, you protect your independence and help your loved ones during difficult times.

For more information, see the following articles:

• What Is an Advance Directive?
• Witness and Notary Requirements for Advance Directives
• Advance Care Planning for Different Medical Conditions
• Power of Attorney for Health Care: What Powers Can You Grant?

You can learn more about making health care directives in WillMaker’s Legal Manual.