A health care proxy (also known as a durable power of attorney for health care, medical power of attorney or appointment of a healthcare agent) is a document that lets you to appoint another person (a proxy or agent) to express your wishes and make health care decisions for you if you can not speak for yourself.

Naming a health care agent is one of the most important things you can do to ensure that you always get the health care you would prefer.

Typically, you don’t have to be terminally ill for a health care proxy to go into effect. You only need to be unable to communicate your wishes due to temporary or permanent illness or injury. In some cases a doctor may have to certify that you are incapacitated.

If you regain the ability to make your own decisions, you will again be able to speak on your own behalf. You should look at the health care proxy document periodically to make sure your agent is still the person you want to make decisions for you. If your preference changes, you can appoint a new agent.

As long as you give your agent permission, they will usually have the flexibility to make most treatment decisions and access any medical records that you would. However, you can place restrictions on the power of your health care agent if you specifically state these limits in the document.

It is critical to appoint someone:

  • Who you trust
  • Who knows you well and understands your medical preferences
  • Who will be assertive in making decisions
  • Who will honor your wishes

Things you should discuss with your agent:

  • Personal attitudes towards health, illness, dying and death
  • Religious beliefs
  • Feelings about doctors and other caregivers
  • Feelings about palliative (comfort) care versus life-sustaining treatments like artificial nutrition and hydration
  • Treatment preference if you are unconscious for a long time and not expected to recover

Your health care agent is supposed to make decisions based on your wishes and preferences. If issues come up that haven’t been discussed, your agent is suppose to act in your best interests.

Ideally, you should have a health care proxy and a living will that states your preferences for end-of-life treatments. The living will can act as a guide for your agent and your doctors to make sure your preferences are followed. Many states combine proxies and living wills into one advance directive document.

Some important things to know about health care proxies:

  • Health care proxy documents usually let you name a second person who can act as your backup agent if your primary agent cannot fulfill their duties. You should always name a backup agent.
  • If you do not appoint a health care proxy and can’t make health care decisions, state law determines who can make decisions on your behalf.
    • Most states have laws that let close family members and others (surrogates) to act on your behalf if you haven’t appointed a health care agent. But you may not want these people to make decisions for you.
    • In a few states, if you fail to appoint a health care agent, decisions about health care may be left to your doctor or hospital administrators. In these states, your loved ones may have to go through a costly, time-consuming court process to get the legal right to make medical decisions for you. This is called guardianship or conservatorship.
  • If there is no one you trust to make health care decisions for you, you don’t have to name anyone as your agent. You can instead create a living will to advise your doctors about your preferences.
  • A health care proxy generally only gives your agent the power to make medical decisions for you. Decisions about things such as health insurance may be considered a financial, not a medical decision depending on state law. It’s generally best to consult with a lawyer to appoint a power of attorney for those types of decisions.
  • You don’t need a lawyer to write a health care proxy. You can use a standardized form and tailor it to your needs, but make sure that it meets all of your state’s legal requirements. Discuss the document with your health care agent and your loved ones. Give a copy of the document to your health care agent and to your providers.