Medical power of attorney in Oregon: how it works, how to sign

The question under every medical power of attorney is a simple one. If you can't speak for yourself, who talks to the doctor?

Oregon answers it with a document called an "advance directive." Inside it, you appoint a "health care representative" and write instructions for that person. This page covers how to sign one, who can't be your witness, how end-of-life wishes fit in, and what happens if you name nobody. It is part of our guides to estate planning state by state. For the basics of the role, see what a medical power of attorney is.

How do I sign an advance directive in Oregon?

Oregon is more formal here than with money matters. An advance directive signed by an Oregon resident, or by anyone while in Oregon, must be in substantially the form set out in the statute (ORS 127.529). You can't simply write your own letter.

You sign it, and then it needs one of these (ORS 127.505 to 127.529):

• Two adult witnesses, who each see you sign or hear you acknowledge your signature, and then sign, or
• A notary.

One more step is easy to miss. Your appointment takes effect only when your health care representative accepts it, by signing the acceptance or by telling a third party they've accepted (ORS 127.505 to 127.529). Have them sign the acceptance the same day if you can.

Oregon's financial power of attorney has no witness or notary rule in its statute. Our Oregon power of attorney guide covers that document.

Who can't be my witness or my representative?

Some people are ruled out as witnesses (ORS 127.505 to 127.529):

• Your attending physician or attending health care provider.
• The person you name as health care representative, or the alternate.

If you live in a long term care facility, one of your two witnesses must be someone the facility designates who meets state rules.

Some people also can't serve as your representative unless they're related to you by blood, marriage or adoption (ORS 127.505 to 127.520):

• Your attending physician or provider, and their employees.
• An owner, operator or employee of the health care facility where you're a patient or resident, unless you appointed them before you were admitted.

The simplest path is a notary, or two friends or neighbors who have nothing to do with your care and aren't named in the document.

What can my representative decide?

Your representative makes the health care decisions you would make if you could, guided by your instructions in the same document. Your representative is a fiduciary: legally required to act in your interest and follow what you wrote.

In daily terms, that usually means talking with your doctors, reading your chart, and agreeing to or declining a test, a surgery or a new medicine in light of your wishes.

Oregon keeps mental health treatment separate. It has its own declaration for mental health treatment (ORS 127.700 to 127.737), if that's something you want to plan for.

Do I need a living will too?

In Oregon, you don't sign a separate one. Oregon has no separate living will statute. Your end-of-life wishes go in the advance directive itself, in the part that gives instructions to your health care representative (ORS 127.529).

That's convenient. One document names your person and tells them what you want, and one signing covers both. Our post on health care power of attorney vs living will explains how the two ideas fit together, and treatment preferences helps you think through what to write.

If you move to Oregon, an advance directive validly signed under another state's law is valid in Oregon (ORS 127.505 to 127.529).

Who decides if I haven't named anyone?

This is where Oregon is unusual. Oregon has no general family-consent list for everyday medical decisions. Its statutory list covers only one thing: withholding or withdrawing life-sustaining treatment (ORS 127.635).

Even then, the list applies only if you can't decide, you have no appointed representative or advance directive that applies, and you're medically confirmed to be in one of four conditions. Those are a terminal condition, permanent unconsciousness, treatment that wouldn't help and would cause permanent and severe pain, or an advanced fatal progressive illness with specified losses of function.

In that case, the decision falls to the first of these who can be located with reasonable effort and is willing:

So a close friend can serve, but only last, and only if no listed relative is available. Before acting, whoever decides must consult with concerned family and close friends. If nobody is available, the attending physician or provider may decide.

For other medically necessary care, Oregon has a narrower backstop. When there's no health care representative and no capable adult relative or adult friend can be found after a reasonable search, a hospital may appoint an ethics-trained health care provider to consent (ORS 127.760).

Our post on medical decisions without a power of attorney compares other states, and the 50-state guide to default decision-makers has the full picture. You can also check your own situation with our short who decides for me tool.

Here is a typical case, a composite. Diane is 73, widowed, and lives in Bend. Her son is in Atlanta and her stepdaughter is in Portland. Her friend Carla takes her to appointments and knows exactly what she'd want. Diane names Carla as her health care representative and her son as alternate, and Carla signs the acceptance at the kitchen table.

How do I choose my representative?

Once the signing is done, the practical questions matter most. Is the person willing? Can they get to the hospital? Will they follow your wishes even when they'd choose differently?

A short checklist:

• They know what you want, because you've told them.
• They can stay calm in a hospital hallway and ask questions.
• They live close enough, or can travel when needed.
• You've named an alternate in case they can't.
• They've signed the acceptance.

Our post on how to choose a medical power of attorney has more questions to ask.

Some people would like a professional standing by, first or behind a friend. A Kinly membership includes a medical power of attorney written for your state, and Trella Trust Company can be named in the role, first or as the backup to someone you choose.

Once your health papers are done, our Oregon probate guide covers what happens to your home and savings later.

Common questions

Does an Oregon advance directive need to be notarized?

Not necessarily. It needs either a notary or two adult witnesses. A witness can't be your attending physician or provider, or the person you name as representative or alternate.

Who makes medical decisions in Oregon if there's no advance directive?

For life-support decisions in defined end-stage conditions, Oregon's list runs from a guardian to your spouse, an adult the family designates, your adult children, a parent, your adult siblings, then any adult relative or friend. Oregon has no general family list for everyday care.

Can a close friend make medical decisions for me in Oregon?

Under the default list, only last, and only for life-support decisions when no listed relative is available. Naming your friend as health care representative in an advance directive puts them first.

Is there an official Oregon form?

Yes. An advance directive signed in Oregon, or by an Oregon resident, must be in substantially the statutory form in ORS 127.529.

Does my health care representative have to sign anything?

Yes. The appointment takes effect only when your representative accepts it, usually by signing the acceptance section of the form.

Sources

• ORS chapter 127 (ORS 127.505 to 127.529, 127.635, 127.700 to 127.737, 127.760) (Oregon Legislature)
• ORS chapter 106 (ORS 106.340) (Oregon Legislature)