Health Care Proxy: Meaning, Rights, How to Choose
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What is a health care proxy?
A health care proxy, also called a medical power of attorney or agent, is someone you appoint to make health care decisions for you if you can’t communicate due to illness or injury. This role is not the same as a financial power of attorney.
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.
What powers does a health care proxy have?
You can limit what your health care proxy can do, but in general, 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 generally must comply with your proxy's decisions to the same extent they would comply with your own.
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How to designate a health care proxy
You can request a health care proxy form from your medical provider or download a health care proxy form online.
The American Bar Association has a free health care power of attorney form for download that it claims are legally binding in all states except Indiana, New Hampshire, Ohio, Texas and Wisconsin.
CaringInfo.com offers free advance directive forms that include power of attorney by state, available for PDF download.
Five Wishes, a nonprofit organization that provides combination documents for end-of-life care, offers an interactive printable version of its directive for $5 and a fully online version for $15.
Once you fill out your form, keep a copy and give a copy to your health care provider to keep on file. In some states, you’ll need two witnesses (who aren’t your proxy) to sign the form for it to be official.
Consult an experienced estate planning attorney for advice about your circumstances and to ensure that these tools are properly executed and legally enforceable in your state.
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Who should be your health care proxy?
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.
How to prepare a health care proxy
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.
