Medical Power of Attorney in Missouri

Missouri uses a 'durable power of attorney for health care' under the Durable Power of Attorney for Health Care Act (RSMo 404.800 to 404.872). To be durable, a power of attorney must be called a 'Durable Power of Attorney,' include the statutory durability language, and be signed by the principal, dated, and acknowledged before a notary (the way real estate deeds are acknowledged). Authority to have artificially supplied nutrition and hydration withheld or withdrawn must be granted specifically in the document, and an agent may never authorize withdrawal of food or water the patient can take naturally with intent to cause death.

A durable power of attorney for health care must meet the same requirements as a durable power of attorney: in writing, signed, dated, acknowledged before a notary, with durability language; authority over artificial nutrition and hydration must be specifically granted. A living will declaration must be in writing, dated and signed by a competent person; unless entirely in the declarant's handwriting, it must be signed by two adult witnesses. A sample (optional) declaration form is in statute.

Any competent person may sign a 'declaration' directing that death-prolonging procedures be withheld or withdrawn if they have a terminal condition. It must be in writing, dated, and signed by the declarant (or by another person in the declarant's presence and at their direction), and, unless it is wholly in the declarant's handwriting, signed in the presence of two or more witnesses at least 18 years old (the person who signed for the declarant cannot be a witness). The statute gives an optional sample Declaration form. The declarant is responsible for telling the attending physician about it.

Missouri does not set out a fill-in statutory financial power of attorney form on the opened pages; instead, a durable power of attorney must be titled "Durable Power of Attorney," contain one of the durability statements prescribed by statute (for example, "THIS IS A DURABLE POWER OF ATTORNEY AND THE AUTHORITY OF MY ATTORNEY IN FACT SHALL NOT TERMINATE..."), and be signed by the principal and dated and acknowledged in the manner required for real estate conveyances (RSMo 404.705). An agent under a health care power of attorney may direct withholding or withdrawal of artificially supplied nutrition and hydration only if the power of attorney specifically grants that authority (RSMo 404.820). RSMo 459.015 provides a living will "Declaration" form; unless written entirely in the declarant's own handwriting, it must be signed in the presence of two or more witnesses at least 18 years old, neither of whom signed for the declarant.