This post explains the Durable Power of Attorney for Health Care (DPAHC), which is the first part of New Hampshire Advance Directive.
The Living Will statute was first adopted in New Hampshire in 1985. It wasn’t until 1991 that the New Hampshire legislature changed the Living Will law, and added new provisions allowing DPAHC’s, commonly known as health care proxies. In 2007, a new form called “The New Hampshire Advance Directive” was adopted, combining the DPAHC and the Living Will.
The most common question from clients when they are reviewing the New Hampshire Advance Directive form is “Why do I need a Health Care Proxy (DPAHC) if I have a living will?” The main difference is that the DPAHC allows you to appoint someone to speak for you and make health care decisions on your behalf, when you are incapacitated and unable to do so. A Living Will is only a document that can become part of your medical record.
A DPAHC becomes effective when a person is incapacitated and unable to make health care decisions. If a person is temporarily incapacitated, his/her appointed agent can make health care decisions until the person regains the capacity to make decisions.
So, who decides whether or not you are incapacitated, making the DPAHC effective? Your attending physician, or Registered Nurse Practitioner (ARNP) must certify in writing that you lack the mental capacity make health care decisions; the certifying doctor/ARNP then places the certification in the patient’s medical record. The Health Care Agent’s authority begins upon the certification of incapacity. If a person later regains the ability to make health care decisions, then the attending physician/ARNP would prepare a certification of capacity and place that document in the patient’s file. Once a patient’s capacity is certified, the Agent’s power to make health care decisions ends.
New Hampshire’s DPAHC form gives broad powers to the agent to make health care decisions for the principal/patient; however, there are certain decisions that the agent cannot make: voluntary commitment, voluntary sterilization, and withholding life-sustaining treatment from a pregnant woman.
Our state’s DPAHC form also provides “check-off” instructions for general Life-Sustaining Treatment, if a person is “near death”, as well as “check-off” instructions for specific Life-Sustaining Treatment, namely artificial feeding and hydration.
Finally, if you have specific medical instructions concerning Life-Sustaining Treatment, there is an optional section for “additional instructions”. Most people leave this area blank; but for some people, such as members of the Christian Science faith, who only allow their own medical practitioners to treat them, this is an appropriate place to define those specific directions.
 The Second part is the Living Will, the subject of the previous article.
 There are some exceptions to this rule