The Role of Healthcare Proxies in Navigating End-of-Life Decisions
When planning for end-of-life care, it can be reassuring to have an advocate if you lose decision-making capacity. Appointing a trusted friend or family member as your healthcare proxy helps keep your unique needs and preferences at the forefront of healthcare decisions. This guide explains the legal process required to elect a healthcare proxy and how to communicate your healthcare wishes effectively.
Key Takeaways
- A nominated healthcare proxy can make decisions about your medical care if you lose capacity.
- Appointing a trusted person as your healthcare proxy helps doctors follow your wishes.
- You can appoint a healthcare proxy by completing your state’s healthcare proxy form.
- A healthcare proxy’s powers don’t apply if you maintain or regain decision-making capacity.
- Regular communication enables your proxy to understand your preferences fully.
What Is a Healthcare Proxy?
A healthcare proxy, also known as a durable medical power of attorney, is a legal document nominating a person to make medical decisions on your behalf if you can no longer make them yourself[1]. Healthcare proxies are most often close family members, but they can also be trusted friends, neighbors, or lawyers. The term can also refer to the person appointed to make decisions. The document contains details of your wishes regarding medical care for your chosen agent to follow. All states recognize healthcare proxies, and anyone can appoint one, regardless of their current health status. Sarah-Jane Williams, an unregistered barrister, adds the importance of checking healthcare proxies created in a different state. While all jurisdictions recognize such proxies, laws vary in terms of the acceptance of agreements made out of state.
Living wills differ from healthcare proxies in their scope[2]. Laws vary from state to state, but living wills generally detail whether you want certain life-sustaining treatments. Healthcare proxies can usually make decisions on a wider range of medical matters. Some states bundle healthcare proxies and living wills into advanced directives.
What’s the Difference Between a Healthcare Proxy and Power of Attorney?
An enduring power of attorney authorizes a person to make legal and financial decisions on your behalf[3]]. Unless you give your chosen agent enduring medical power of attorney, they cannot make healthcare decisions for you.
Power of attorney grants a named person to make specific or general decisions on your behalf, either temporarily or permanently, and can apply even if you have capacity. Meanwhile, a healthcare proxy relates specifically to medical decisions and only applies if you lack decision-making capacity. If you later regain capacity, you can resume making your own healthcare decisions. The person that decides if you have the capacity to make these decisions varies based on your choices and your situation—it could be your appointed decision-maker, a healthcare professional, or a lawyer.
The Role of a Healthcare Proxy in Medical Decisions
State laws govern which decisions your agent can make. However, a healthcare proxy can usually[4]:
- Choose your healthcare provider and hospital
- View your medical records
- Determine which routine and life-sustaining treatments and services your doctor provides
- Decide what happens if you pass away, such as choosing whether to donate your organs and tissue
Through directions in your healthcare proxy document, you can authorize your proxy to decide any matter relating to your care or restrict their authority to particular issues. You can also add stipulations, such as requiring your proxy to consult other loved ones before making decisions.
How to Choose a Healthcare Proxy for Yourself or a Loved One
When choosing a healthcare proxy, consider whether you trust the person to honor your wishes and confirm they’re willing to act as your agent. Ideally, your proxy should understand your personal and religious beliefs about healthcare, illness, and death and be prepared to follow your instructions, even if they conflict with the choices they would make for themselves.
From a practical perspective, your agent should be able to travel to be near you if you lose decision-making capacity. You can nominate backup proxies to make decisions if your primary agent is unavailable.
The Importance of Communicating Your Wishes
According to the American Bar Association, discussing your wishes for end-of-life care with your proxy in advance increases their ability to fully understand and honor your preferences[5]. Discuss any scenarios you feel particularly strongly about, such as your preferences for life-sustaining treatments or comfort care.
Legal Requirements for Appointing a Healthcare Proxy
The legal requirements for a healthcare proxy differ between states. Generally, proxies must be 18 or older and of sound mind. You can’t nominate your healthcare provider or one of their employees unless they are your spouse or close family member.
To appoint a proxy, you must complete your state’s healthcare proxy form. You don’t have to hire a lawyer, although some jurisdictions require you to have the form notarized or witnessed. Your state’s legal aid office or bar association can explain the rules in your jurisdiction.
Where Can I Get a Healthcare Proxy Form?
You can obtain state-specific healthcare proxy forms from your State Attorney General’s Office or local Area Agency on Aging. These forms don’t always transfer between states, so you should complete a separate form for every state in which you spend significant time.
What to Do After a Decision Has Been Made
After appointing a healthcare proxy, provide a copy of the form to your lawyer (if you have one), your agent, and your healthcare provider. Ensure your healthcare provider knows how to contact your proxy if you fall ill.
Over time, your medical or end-of-life care wishes may evolve. Continue communicating with your healthcare proxy and provider and also update your advance directive to reflect any changes. You can change your healthcare proxy at any time by completing a new form and informing your healthcare provider and loved ones.
Common FAQs About Healthcare Proxies
A healthcare proxy can usually make any medical decision you would normally make yourself. However, you can also limit your proxy’s powers to certain issues.
You can change or revoke your healthcare proxy by completing a new healthcare proxy form.
If you don’t have a healthcare proxy and lose decision-making capacity, who makes medical decisions on your behalf depends on state rules. Often, this could be your spouse, a close relative, or a court-appointed guardian.
Make Your Medical Wishes Known
Appointing a trustworthy healthcare proxy ensures your voice will still be heard during end-of-life decisions. It’s never too early to select a healthcare proxy. In fact, making legal arrangements and starting important conversations as soon as possible can help your chosen agent understand and respect your wishes more fully.
Written by Hannah Borrett
Hannah Borrett-Stephens is a graduate of Goldsmiths, University of London and excels at at translating complex information into digestible long-form content for general readers. Her areas of specialism include DIY, senior living, and substance rehabilitation, although her seven years of professional writing experience also make her a strong generalist. Hannah enjoys topics requiring extensive research and delivers accurate, insightful articles for American and British audiences. In her downtime, she enjoys growing her own vegetables in her garden and walking in the English countryside surrounding her home.
Edited by Alyssa Hill
Alyssa Hill is an experienced editor and health writer. She holds an M.A. in journalism from the University of Arizona and is also a certified somatic practitioner. A former content manager for multiple start-ups in the marketing and health/medical industries, Alyssa has extensive experience writing medically accurate and well-researched content, editing articles for clarity and SEO, adhering to strict guidelines, and ensuring all content is up to standards.
Subject Matter Expert Sarah-Jane Williams, LL.B(Hons)
Sarah-Jane Williams is a seasoned writer with a robust legal background, holding an LL.B (Hons) Bachelor of Laws and a Bar Training Course certification with a 'Very Competent' grade. She was called to the Bar at Lincoln's Inn. Her expertise as a legal SME is complemented by her diverse writing portfolio covering law, senior care, culture, and travel. With over a decade of writing experience, Sarah-Jane's work spans a wide range of subjects from engineering and health to pet care and spiritualism. Her global perspective is enriched by extensive travel and residences across four continents, enhancing her cultural insights and intercultural communication skills. Sarah-Jane's multifaceted background, including roles in housing, research, and advisory capacities, adds depth to her writing, making her a versatile contributor to any niche.
Sources
Medicare Interactive. (n.d.). Health care proxies. Sourced from https://www.medicareinteractive.org/get-answers/planning-for-medicare-and-securing-quality-care/preparing-for-future-health-care-needs/health-care-proxies
American Bar Association. (n.d.). Living wills, health care proxies, and advance directives. Sourced from https://www.americanbar.org/groups/real_property_trust_estate/resources/estate-planning/living-wills-health-care-proxies-advance-directives/
American Bar Association. (n.d.). Power of attorney. Sourced from https://www.americanbar.org/groups/real_property_trust_estate/resources/estate-planning/power-of-attorney/
National Institute on Aging. (n.d.). Choosing a health care proxy. Sourced from https://www.nia.nih.gov/health/advance-care-planning/choosing-health-care-proxy
American Bar Association. (2020). Health care advance planning toolkit. Sourced from https://www.americanbar.org/content/dam/aba/administrative/law_aging/2020-tool-kit-hcap.pdf