Do I need to produce original documents at hospital?
January 7, 2014 6:56 PM   Subscribe

My same-sex partner and I have executed health care powers of attorney and related documents. Rather than bringing a bulky envelope with the original documents every time we travel, I'd like to scan and upload the documents so that, in an emergency, I can access them on my phone or via email and show/email them to the hospital staff. Is that likely to be a problem? Do hospitals require original documents or certified copies, with the raised seal and all that jazz? Or are digital/scanned copies sufficient? Has anyone been in a situation where they had to produce such documents in an emergency situation and photocopies were not honored?
posted by southern_sky to Law & Government (8 answers total) 3 users marked this as a favorite
Hospitals are probably going to care less about this than you think. I say this as a widowers who's wife was in and out of the hospital and hospice before she died. When she was no longer able to make decisions for herself, everyone just deferred those decisions to me. Nobody ever asked to see any sort of paperwork or anything. I realize that as a same sex couple you may have special considerations here, especially if other family has differing opinions to you and your partner as to how to treat these sorts of situations, but in general, if someone is still competent to make their own medical decisions, then they'll be allowed to, and if they're not, then the hospital staff will defer to family as they have no way of knowing what sort of legal paperwork may or may not exist. In such a situation, it's up to the family to present any existing legal documents to the hospital, which is a sort of catch-22 if the purpose of the document was to prevent your family from making decisions you didn't agree with in the first place.

In any case, I would expect that if you did present such documents, the hospital would accept copies without issue. There are lots and lots of copies of documents floating around hospitals and they seem to work without issue.
posted by tylerkaraszewski at 7:50 PM on January 7, 2014 [1 favorite]

I had healthcare POA for my uncle, i.e., I was family but not immediate family. I was asked for copies of the DNR and living will many times, and no one ever had a problem with photocopies.
posted by bricoleur at 8:01 PM on January 7, 2014

Make photocopies and get them signed by a notary public?
posted by monospace at 8:03 PM on January 7, 2014

I usually draft a provision in DPOA instruments for my clients authorizing use of photocopies by the Agent/AIF in lieu of the original. Does yours have a similar clause? If so, that's what you can point to if anyone asks. If not, I'd be surprised if a medical provider demands an original HPOA in lieu of a copy, and I've never heard of anyone having a problem with a provider demanding an original. This may vary by jurisdiction though and it might be more of an issue in living will situations in which the hospital wants to do a little bit more due diligence and make sure the copy is valid before pulling the plug on someone.

What I have had happen is banks demand execution of separate POAs on their proprietary forms in lieu of a client's properly executed document, which is annoying, but understandable when you have a large company doing business nationwide that wants to deal with a single form that they trust rather than deal with a variety of different instrument forms from all different jurisdiction.
posted by Dr. Zira at 8:22 PM on January 7, 2014 [2 favorites]

I sent an original to my doctor so she could provide it to other health care professionals upon request.
posted by Sukey Says at 8:23 PM on January 7, 2014 [3 favorites]

I worked in emerg depts for many years. I have to say that my experience was that emerg staff were typically not looking to challenge the declared status of POAs etc.; there often isn't enough time to do so, and people are generally still trusting enough of one another to assume good faith. Decisions have to be made quickly, and part of providing consent is being available to provide consent, so if you're there and seem reasonable, it would be my hope that you'd be allowed to provide consent. My perspective may be biased due to the fact that I've worked in fairly major Canadian urban centres.

Having the info stored on your phone can't hurt. However, that being said, in this age of password-protected phones, emergency staff still look through wallets for info, so have a card or something in your wallets which makes your arrangement clear. Also, there are some online storage sites for such documents, although they typically charge a small fee. Tiny cash canisters attached to your keychain are also useful for storing a bare minimum of documents. Finally, if you are going somewhere remote or dangerous, you could actually get medic alert type bracelets or pendants which declare your arrangement. Note that a simple declaration of POA is much easier to store than is a whole laundry list of living will what-ifs.

Also, if possible, letting other family members know of your arrangement may be helpful in case a cautious physician has lots of questions and insists on calling the person s/he thinks should be the substitute decision maker.

Oh, and it's perhaps somewhat odd, but I can tell you as a social worker that you will be given a much harder time trying to exercise a financial POA as opposed to a treatment decisions POA (saying yes to life threatening surgery for someone else is easier than trying to get in their bank account!) For that reason, originals of financial POA docs are more crucial than are treatment decision POA docs.
posted by analog at 8:42 PM on January 7, 2014 [2 favorites]

I also work in an emergency department. As long as you have paperwork in some format, you should be fine.

The hospital/physicians care about the paperwork because they don't want to be put in a decision where a disagreement arises about what should be done between one family member and another. If a situation like this comes up, you might want to have the original on hand, but you'll have time to get it. If your spouse is, god forbid, in some critical situation in which you need to make a decision about whether they get put on a ventilator or get chest compressions, the decision will need to be made immediately and you should be able to make it without question.*

I say this as a physician who has mainly worked in very LGBT-friendly parts of the country. Whether someone might give you a hard time in some other part of the country just because you are who you are - that might happen but it would not be a standard way of treating a person in that situation, that would be the behavior of a jerk who would probably find ways of being awful to you regardless of what format of documents you have on hand.

* In general, spouses are not questioned about paperwork because legally, they are the next of kin. If no paperwork exists, the next of kin is the default healthcare decision maker. You ought to have the same rights as any other spouse, but because you have a same sex partner, you might face increased scrutiny.
posted by treehorn+bunny at 8:58 PM on January 7, 2014

My primary care doc asked me to provide her with a copy of my POA and related documents so they would be in my chart for future reference. I live in a small, 1-hospital community, and this is apparently standard for new patient visits.

When I had my estate planning done, my attorney also gave me wallet cards with her firm's contact details on it, like what @analog mentioned upthread about emergency staff having to look through wallets for info. The card simply reads: "To Whom It May Concern, My estate planning documents are deposited with the XYZ Law Firm at [address] & [phone]."
posted by hush at 5:05 AM on January 8, 2014 [1 favorite]

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