Oregon Healthcare Power of Attorney Requirements

The principal designates a health care representative, and may designate one or more alternates, using either the standalone representative-appointment form (Section 127.527) or the full Advance Directive form (Section 127.529). The appointment becomes effective only once accepted by the representative (Section 127.510, Section 127.525). Oregon law does not use power of attorney or attorney in fact terminology for this appointment.

The health care representative has all the authority over the principal's health care that the principal would have if capable, subject to statutory limits, and has priority over other persons to act for the principal when known to be available. The representative may receive and review medical records and consent to their disclosure.

The Advance Directive is effective once signed by the principal and witnessed or notarized. The appointment of the representative becomes effective only when the representative accepts it. Unless limited by its own terms, the document continues until the principal dies or it is revoked, suspended, or superseded.

Incapacity is determined by the opinion of the principal's attending physician or attending health care provider, or by a court in a proceeding to appoint or confirm a representative. A single physician's or provider's opinion is enough to trigger the representative's general authority. A stricter, second-physician medically confirmed standard applies only to decisions to withhold or withdraw life-sustaining treatment (Section 127.540(5)(b)).

Federal HIPAA regulations govern how the representative can be authorized to access the principal's protected health information once the document is in effect.

The Advance Directive form lets the principal state preferences for life-sustaining treatment and tube feeding across four defined medical scenarios, including a terminal condition, permanent unconsciousness, an advanced progressive illness, and extraordinary suffering.

The Advance Directive form includes a section where the principal can describe values, what matters most, and preferences for place of care, such as a hospital, nursing home, or the principal's own home, which the representative must consider. The Advance Directive Advisory Committee's mandatory form elements are set out at Section 127.533.

The Advance Directive remains effective as to an anatomical gift under Section 97.953 even after the principal's death (Oregon Revised Statutes Section 127.510(6)). The principal's wishes on organ and tissue donation may be stated in the Advance Directive or in a separate document.

A principal who wants to give advance instructions specifically for mental health treatment should consider Oregon's separate Declaration for Mental Health Treatment. If a valid declaration and a valid Advance Directive give inconsistent directions, the declaration for mental health treatment governs to the extent of the inconsistency (Oregon Revised Statutes Section 127.545(6)(b)).

A capable principal may revoke the Advance Directive at any time and in any manner. Decisions to withhold or withdraw life-sustaining treatment or artificial nutrition and hydration may be revoked at any time in any manner the principal is able to communicate, regardless of overall capability. Revocation is effective once communicated to the attending physician, attending health care provider, or the representative, who must then relay it to the attending provider if the principal is incapable. A form appointing a representative is suspended, not automatically revoked, if all named representatives withdraw, or if the representative is the principal's spouse and a dissolution or annulment petition is filed and not reaffirmed.

The principal signs before two adult witnesses, or alternatively has the signature notarized, with no witnesses required if notarized. As of a 2018 law change, witnesses may not be the principal's attending physician or attending health care provider, or the principal's appointed representative or alternate. If the principal is a long term care facility resident at signing, one witness must be an individual designated by the facility under Department of Human Services rule.

The principal may name one or more alternate health care representatives who act if the primary representative is unable, unwilling, or unavailable to make timely health care decisions.

A representative accepts an appointment by signing the acceptance or by representing to a third party that they have accepted the role. Acceptance is required, not optional, for the appointment to be effective: Oregon Revised Statutes Section 127.510(2)(d) states the appointment is effective only when accepted.

The Advance Directive form includes a section where the principal may describe spiritual or religious beliefs relevant to care, such as views on blood product transfusions, for the representative and care providers to know.

An Advance Directive or form appointing a health care representative executed by an adult who resided in another state at the time of execution is validly executed for Oregon purposes if it complied with the laws of that state, the laws of the state where the principal was located at execution, or Oregon law.

Oregon law provides a real court petition process for resolving disputes over an Advance Directive, including determining whether a principal is incapable, whether an appointment or the directive is valid, whether the representative's acts breach a duty, and disqualifying a representative found to have violated those duties. The petition may be filed by the principal, the representative, certain relatives, a guardian, a conservator, or the attending physician or provider.