Health Care Proxy or Medical Power of Attorney (POA): Meaning, Rights, How to Choose

A health care proxy, also called a medical power of attorney (POA) or agent, is someone you appoint to make health care decisions for you if you can’t communicate due to illness or injury^[0]

Anyone over 18 can name a health care proxy by filling out a proxy form or advance directive. If you don’t designate a health care proxy and become unable to communicate, state laws may automatically select someone you wouldn't choose to make important health care decisions, such as an estranged family member^[0]

A health care proxy can make decisions about medical procedures to diagnose or treat your condition, including resuscitation and other lifesaving measures. Your medical practitioners must comply with your proxy's decisions to the same extent they would comply with your own.

You can limit what your health care proxy can do and even require them to consult a doctor or family members before making certain decisions.

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1. Request a health care proxy form from your medical provider or download a health care proxy form online, which may also be called a health care or medical power of attorney designation form. These generally cost less than $20 and are sometimes free. Many online will makers include medical power of attorney forms in their estate planning packages.

2. Two witnesses (who aren’t your proxy) may need to sign the form for it to be official in some states. Check your state rules or consult an experienced estate planning attorney to ensure you’re meeting the requirements.

Give copies to your health care provider, health care proxy and anyone else who should be in the loop, such as close family members.

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There are several factors to consider when choosing a health care proxy. Here are a few:

• Respect for your preferences. Your proxy must prioritize your wishes over theirs and make choices that align with your values. They should be able to understand your religious and moral beliefs and your attitude toward health care settings, illness and death. “Your proxy should be someone you are comfortable sharing your philosophy on future health care and quality of life with,” says Joan Smith, director of social work services at Tufts Medical Center. “This is someone who you trust to respect your wishes until the end.”

• Relationship. In most states, your next of kin will be your automatic proxy if you don’t name one. “It’s especially important to name a proxy if there’s someone you do not want to speak on your behalf,” says Kate DeBartolo, senior director of The Conversation Project, which focuses on encouraging people to talk about their end-of-life health care wishes. If you’re estranged from your biological family, for example, selecting a partner or friend can ensure your current wishes are valued.

• Ability to make decisions. Your proxy must be ready to communicate with doctors about any issues. “Ask yourself, ‘Who’s able to speak up on my behalf? Are they comfortable making quick decisions? Asking questions? Pushing back against medical practitioners?'” DeBartolo says. In some cases, a family member may not be the best choice, as the people closest to you may have a hard time carrying out wishes you may have for life-ending treatment.

• Have a conversation. Speak honestly with your proxy about your preferences for end-of-life treatment. “It’s essential to discuss ahead of time,” Smith says. “Sometimes people appoint a friend or relative, assuming that they’ll be OK making these important decisions when they’re not.”

• Keep your proxy updated. Your wishes may shift in the event of aging or a terminal diagnosis, but telling your proxy what’s most important to you can make life-or-death decisions much more manageable. The Conversation Project, an Institute for Healthcare Improvement initiative, has a guide to help you tell your proxy what’s important to you.

• Loop in your loved ones. Families can disagree over a person’s final wishes. To avoid end-of-life conflict, tell your close family members in advance who you’ve chosen as your proxy and why. A simple email to your loved ones can help them prepare and, when the time comes, grieve in peace without blame or conflict.

• Consider your proxy’s role. Some proxies need to make difficult, life-or-death decisions for their loved ones. Make sure to remind your chosen proxy that they’re advocating for choices you’ve made, not deciding for you. “Your proxy should know that if their decision results in the end of your life, it’s not their fault — it’s a result of the illness or injury,” DeBartolo says.