Continuing Power of Attorney
Advance Medical Directive in Israel
Specifying Your End-of-Life Wishes
An advance medical directive (הנחיה רפואית מקדימה) gives you control over the medical treatment you receive if you become terminally ill or permanently unconscious. Adv. Liron Elmaliach prepares AMDs alongside Continuing Powers of Attorney for comprehensive future planning.
What is an Advance Medical Directive?
An advance medical directive (הנחיה רפואית מקדימה) is a legally recognised document in Israel that records your wishes regarding medical treatment if you become terminally ill or permanently unconscious. It is grounded in the Patient Rights Law 5756-1996 and the Dying Patient Law 5766-2006, which together establish the right of every competent adult to decide in advance what interventions they do — and do not — consent to.
In the AMD you can specify whether you consent to cardiopulmonary resuscitation, connection to mechanical ventilation, artificial nutrition and hydration, and other life-sustaining interventions. You can also record your values — for example, that you prioritise quality of life over its prolongation, or that you wish to spend your final days at home.
Any competent adult aged 17 or over may sign an AMD. The document must be signed before a physician who verifies that you understand its contents. Once signed and registered in the national Ministry of Health registry, it is valid for five years and can be renewed at any time before expiry.
Because the AMD directly affects the most sensitive medical decisions imaginable, it is important to draft it with care — using precise language that leaves no room for misinterpretation by hospital staff under pressure.
How an AMD Complements a Continuing Power of Attorney
The AMD and the CPoA serve different but complementary functions. The AMD tells doctors what you want; the CPoA appoints a person — the healthcare proxy — to make real-time decisions when circumstances arise that the AMD does not explicitly address. Together they provide complete protection.
When a valid AMD exists and its instructions are directly applicable, those instructions take precedence — even over the wishes of the healthcare proxy. This ensures that your autonomy is preserved. In ambiguous situations the proxy steps in, guided by the values and preferences you recorded in the AMD and in the CPoA itself.
Where a family disagrees about treatment, or where medical staff have doubts, the hospital ethics committee may be convened. Having both a properly drafted AMD and a clearly authorised proxy under a CPoA dramatically reduces the likelihood of conflict — and ensures that the committee has clear written evidence of your wishes.
Remember to renew your AMD before the five-year validity period expires. Store a copy with your healthcare provider (Clalit, Maccabi, Meuhedet, or Leumit), in the national registry, and with your appointed healthcare proxy. Inform close family members where the original is held so that it can be located quickly in a medical emergency.
Adv. Liron Elmaliach routinely prepares AMDs as part of a comprehensive future-planning package alongside the CPoA — ensuring both documents are consistent, precise, and registered correctly.
Frequently Asked Questions — Advance Medical Directive
Everything you need to know about advance medical directives in Israel
Prepare Your Advance Medical Directive
Advance Medical Directive — Free Initial Consultation
In conjunction with a Continuing Power of Attorney