Here is the link to the Statute which sets forth the form of health care power of attorney:
Here is the link to the RI Department of Health's information about health care powers of attorney and living wills, and they have forms. Their health care power of attorney is different from the statutory one:
Rhode Island has both a health care durable power of attorney and a living will.
New [Neon Pink!] Rhode Island Form of Advance Directive. Medical Orders for Life Sustaining Treatment (MOLST) are instructions to follow a terminally ill patient’s wishes regarding resuscitation, feeding tubes and other life-sustaining medical treatments. The MOLST form can be used to refuse or request treatments and are completely voluntary on the part of patients. These orders can supplement Do Not Resuscitate (DNR) instructions or a COMFORT ONE bracelet.
Statutory Form Durable Power of Attorney for Health Care
A Durable Power of Attorney for Health Care (Durable Power) is a written declaration by an individual designating another person (Agent) to be the that person's agent (Attorney in fact)to make health care decisions on that person's behalf at any time that the individual is incapacitated and/or unable to make treatment decisions for himself or herself. Your Durable Power needs to be communicated to your attending physician.
Unless limited in your Durable Power, your Agent is authorized to make all health care decisions on your behalf. The individual you appoint as an Agent may not be associated with the health care provider or facility that is involved in your care or treatment unless the person is also a relative.
Your Durable Power must be in the exact form specified by taw, in writing and signed by you. You must be at least 18 years old and competent at the time of the execution of the document. Your Durable Power must be witnessed by two adults who know who you are but are not associated with the health care provider or facility that is involved in your care or treatment. At least one of these witnesses must be neither a relative nor a potential heir or beneficiary to your estate.
Health care durable power of attorney
Appoint someone to make health care decisions for you
May include guidelines and limitations for agent
Must use required form in legislated format
Encompasses all health care decisions, including requesting or refusing treatment or care
Applies to any kind of illness or injury that incapacitates you
Requires that you have someone you trust who is willing to take on this responsibility
Can be flexible to changing circumstances
Is easily revoked, orally or in writing
Declaration (Living will)
A Declaration (commonly referred to as a Living Will) is a written document instructing your attending physician to withhold or withdraw life-sustaining procedures in the event of a terminal condition.
A life-sustaining procedure is any medical procedure or intervention that will serve only to prolong the dying process of a terminally ill person. It does not include comfort measures or pain medication.
A terminal condition is an incurable or irreversible condition that, without the administration of life-sustaining procedures, will result in death within a relatively short time.
Your Living Will will become operative only when your condition is diagnosed as terminal, you are unable to make treatment decisions, and the existence of your Living Will is communicated to your attending physician.
Spells out, in writing, under what circumstances you want medical care or treatment withheld or withdrawn
Refers only to withholding or withdrawing care
Applies only to terminal conditions that leave you unable to make or communicate decisions
Does not put decision-making responsibility on a specific person
Its conditions do not change and may not cover every possible medical situation
Is easily revoked, orally or in writing
May not be effective if you are pregnant
Must specifically outline nutrition and hydration wishes
Comparison of health care durable power of attorney and living will
A Living Will does not extend to artificial feeding and/or hydration unless it expressly states that it applies to these procedures in the document. If your Living Will does not include an explicit authorization to withhold or withdraw artificial feeding, the hospital will assume no such authorization exists, and food and hydration shall be provided as appropriate.
Your Living Will must be in writing and signed by you or your agent at your direction. You must be at least 18 years old and competent at the time of the execution of the document. Your Living Will must be witnessed by two adults who are unrelated by blood or by marriage to you. You may revoke your Living Will at any time and in any manner without regard to your mental or physical condition.
Your Living Will will not be followed if you are pregnant and your attending physician believes the fetus could develop to the point of live birth with the use of life-sustaining procedures.