Are you sure this is not what you have described? Or are you looking for the directive for the UK?
PART 3 ? Power of Attorney With Guardianship Directive WTB&TS JAN 2003
. . . The power of attorney especially includes the following matters (I have initialed what is applicable):
(a) To consent to, refuse, or withdraw consent to any or all types of medical treatment, surgical procedures, diagnostic procedures, and prescribed medication, even if I die because of such or could suffer heavy or prolonged health damage. The power of attorney also includes the following: the right to consent to the use of palliatives to relieve severe and almost intolerable pain; to receive any information, oral or written, pertaining to my psychical or mental health; to review medical records, including my medical history and hospital records, and to get copies of these, as well as to consent to passing on this information. At the same time, the power of attorney includes the authority to release all physicians treating me from the medical confidentiality incumbent upon them. My legal agent must be given the needed medical explanations.