Advance Healthcare Documents for Israel
Hebrew/English versions of two healthcare power of attorney forms and a conversation guide for use in Israel
שני טופסי ייפוי כוח רפואי ומדריך שיחה על העדפות לגבי טיפול בסוף החיים
These documents have been reviewed by the relevant government ministries and are legally binding in Israel.
Legal Documents
Continuous Medical Power of Attorney - Form D
ייפוי כוח רפואי מתמשך - טופס ד
The Form D Continuous Medical Power of Attorney allows you to appoint one or more agents (Powers of Attorney) to make medical decisions on your behalf if you are deemed to be lacking the mental capacity to do so.
This document is not relevant for end of life decisions. For such cases you must complete a Medical Power of Attorney Abridged Form of the Dying Patient Act, available below.
You can download the form to appoint one Power of Attorney or the form for appointing multiple Powers of Attorney (recommended).
The signed and completed document is submitted to the Ministry of Justice’s Guardian General (האפוטרופוס הכללי) and becomes active only after your chosen agents notify the Guardian General that you lack the capacity to make your own decisions. This determination is based on a professional assessment by a doctor or a psychologist with the relevant certification.
Medical Power of Attorney - Abridged Dying Patient Act
ייפוי כח נוסח מקוצר
The Abridged Power of Attorney form enables you to appoint a representative to make treatment decisions on your behalf if, in the future, you meet both of the following conditions:
1. You are diagnosed as a dying patient (prognosis of six months or less to live).
2. You lack the mental capacity to make your own healthcare decisions.
This form also provides the option to issue advance healthcare directives regarding certain interventions when you are terminally ill.
To address other situations where you lack mental capacity but are not considered a dying patient, you should complete a Continuous Medical Power of Attorney (Form D) found above.
Download the Power of Attorney - Abridged Version -
Dying Patient Act with an explanatory guide
ייפוי כוח לפי חוק החולה הנוטה למות - נוסח מקוצר
Once completed, you must mail the original copy of this Power of Attorney – Abridged Version to:
Center for Advance Healthcare Directives
MINISTRY OF HEALTH
39 Yirmiyahu Street
Jerusalem 9446724
המרכז להנחיות רפואיות מקדימות
משרד הבריאות
רח’ ירמיהו 39
ירושלים 9446729
Important: Along with the document, you must include a full photocopy of your Teudat Zehut including the sefach (appendix on blue paper).
Once completed, you must mail the original copy of this Power of Attorney – Abridged Version to:
Center for Advance Healthcare Directives
MINISTRY OF HEALTH
39 Yirmiyahu Street
Jerusalem 9446724
משרד הבריאות
רח’ ירמיהו 39
ירושלים 9446724
Important: Along with the document, you must include a full photocopy of your Teudat Zehut including the sefach (appendix on blue paper).
The Conversation Guide
Family members may need to choose a plan of care in the face of medical uncertainties. Given the individualized nature of each case, end-of-life decision making requires a thoughtful and personalized approach.
By completing this guide, you will help those that care for you – your proxy, family, rabbi, and healthcare providers – to better understand your goals and preferences so they can apply them to each unique situation. The Conversation Guide will help you navigate the conversations which are difficult to start but essential to have. It is a gift to your loved ones to provide them with greater clarity and avoid tensions or guilt caused by speculating about your values and preferences. Meaningful conversations bring families together.
The Netivot conversation guide is not a formal legal directive. It does not need to be signed or witnessed and may be used anywhere in the world. The ultimate goal is to generate healthy communication and ongoing conversations about these topics in an open and loving manner.
A legal proxy or power of attorney form is only valid in the country where it was created. To ensure your wishes are respected, you must complete an advance directive specific to each country where you reside.
Ematai has created advance directives in the United States, Ontario, Quebec, and the UK. You can download the documents here >
Netivot is a free service to the community. Please support this initiative with a donation.
You are encouraged to consult with your own attorney for any questions about your specific needs or local requirements. Nothing on this website or within any element of the Netivot healthcare directive or conversation guide constitutes the offer of legal advice from Ematai.
