Okay, I finally found it. Act 169. Enacted by Senate (SB 628 ) Nov 19, 2006. Signed by Gov. Rendell the next day.
This is a dangerous law. On the plus side, it does offer some protection for vulnerable individuals. If your health care agent orders your death, you can rescind the order even if you're not competent, assuming you're able to inform the doctor. That's the only protection I found. Everything else is geared toward killing you.
There is no need for a person to express a desire to forgo any treatment. If you don't specify, there can be no presumption that you would want to live.
Your health care agent does not need to prove he's following your wishes. He's only required to consider them, as well as other factors like your condition, prognosis, finances, etc. Your expressed wishes bear no more weight than any other factor. There is no provision for challenging the decision to starve and dehydrate you to death.
If you do not assign a health care agent, one will be appointed to you. That agent has the same power as one that you could have assigned personally. They have the power to have you starved and dehydrated to death, and there is no provision for anyone else to dispute this. The law is unclear, but it appears your health care provider is the one who appoints your health care agent, according to preset guidelines. Your health care agent can be replaced "for cause," but they don't say what constitutes cause, or the procedure for replacing them. I guess the doctor just picks the next available relative, friend, or neighbor on the list.
Health care workers are protected from prosecution, whether they act in accordance with your wishes or not. As long as they act in good faith. And that doesn't mean they have faith that they're following your wishes. Your wishes bear no more weight than any other factor. They just have to have faith that they're doing the right thing, whether you like it or not.
If you sign an advance directive, it goes into effect when you are "determined by the attending physician to be incompetent and in a terminal condition or in a state of permanent unconsciousness. They don't require the team of doctors that the Nazis required. Just one doctor. They allow no distinction between terminal, end-stage, and unconscious. There may be procedures you would wish to forgo during the end stage of a terminal disease, but if you put that in writing, you will be denied those procedures at any point during the terminal illness, or even in the absence of a terminal illness if you're "permanently unconscious." They removed the wording that would have specifically allowed you to make different provisions for a terminal condition as opposed to brain damage. It's now considered one and the same. And you don't really have to put it in writing at all. You will have a health care agent, whether you assign one, or someone else does. That health care agent wields enormous power to make life and death decisions for you, based in part on what he thinks you might want, but not entirely.
Ain't we got fun?
We have no idea just how many people are duped by lawyers and doctors to sign these kinds of directives.
What a shame. What a crime.
Evil is on the march. This is nothing but a broad license to murder, concealed in lawyerly language.
22 (c) Format of bracelet.--The department shall, with the
23 advice of the Pennsylvania Emergency Health Services Council and
24 with the assistance of the regional emergency medical services
25 councils, make available standard bracelets for issuance to
26 patients by attending physicians. The bracelets shall be uniform
27 in design and shall, at a minimum, on the face clearly indicate
28 OUT-OF-HOSPITAL DNR and the name of the patient and attending
29 physician as well as the dated signature of the attending
30 physician.