Medical Power of Attorney in Louisiana: Healthcare Mandate Rules

A medical power of attorney in Louisiana is legally called a healthcare mandate. It authorizes a designated mandatary to make medical, surgical, and treatment decisions on your behalf when you are unable to communicate or lack the cognitive capacity to make those decisions yourself. The instrument is governed by Louisiana's civil law framework, and the terminology matters — hospitals and medical facilities in the state expect to see "mandate" and "mandatary," not "power of attorney" and "agent."

What a Healthcare Mandate Covers

A properly drafted healthcare mandate in Louisiana grants the mandatary authority over:

• Medical treatment decisions — approving or refusing surgeries, diagnostic procedures, medications, and therapies
• Facility placement — authorizing admission to hospitals, nursing homes, assisted living facilities, or rehabilitation centers
• Access to medical records — requesting, reviewing, and sharing health information under HIPAA
• Physician selection — choosing or changing attending doctors and specialists
• End-of-life adjacent decisions — pain management protocols, palliative care, hospice enrollment

A healthcare mandate does not automatically cover decisions about withdrawing life-sustaining treatment. That authority belongs to a separate instrument — the Living Will (Declaration Concerning Life-Sustaining Procedures under La. R.S. 40:1151). Many families execute both documents together to eliminate gaps in coverage.

Execution Requirements

A healthcare mandate has more flexible execution rules than a financial mandate. It can be executed in one of two ways:

1. Before two competent, disinterested witnesses — both witnesses must be adults who are not named as the mandatary and have no financial interest in the principal's estate
2. Before a notary public — the notary's acknowledgment substitutes for the witness requirement

Many Louisiana residents choose to include the healthcare mandate in the same authentic act ceremony as their financial mandate (before a notary and two witnesses), creating a single unified document with one signing event.

What Happens Without One

If you become incapacitated without a healthcare mandate, medical decision-making authority defaults to a statutory priority list under La. R.S. 40:1159.4:

1. A judicially appointed curator (if one exists through interdiction)
2. Your spouse
3. An adult child (majority rules if multiple)
4. A parent
5. A sibling

This hierarchy creates problems in blended families, estranged relationships, and situations where the statutory priority does not match the patient's actual wishes. A healthcare mandate overrides this default list and places decision-making authority exactly where you want it.

Healthcare Mandate vs. Living Will

These two instruments serve different purposes and activate under different conditions:

Healthcare mandate — covers all medical decisions during any period of incapacity, whether temporary (post-surgical sedation) or permanent (advanced dementia). The mandatary makes real-time decisions based on their judgment of the principal's best interests.

Living will — a narrow directive that instructs physicians to withhold or withdraw life-sustaining procedures only when two independent physicians certify that the patient has a terminal, incurable, or irreversible comatose condition. It is a standing order, not a decision-maker.

Louisiana residents who want complete coverage execute both. The healthcare mandate handles the 95% of medical situations that do not involve imminent death. The living will handles the final 5%.

Registration and Accessibility

Louisiana allows voluntary registration of healthcare mandates with the Secretary of State's Registry of Advance Directives for a $20 fee. Registration provides a laminated wallet card and, for qualifying declarations, a DNR bracelet. Registration is not required for legal validity, but it gives emergency medical personnel a reliable way to locate the document.

Regardless of registration, keep the original document accessible. Give copies to your mandatary, your primary care physician, and any hospital where you receive regular treatment. The Louisiana Power of Attorney Kit includes both financial and healthcare mandates with coordinated execution instructions so nothing falls through the cracks.

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