A healthcare proxy is a document that gives someone the power to make healthcare decisions for a person who is unable to do so.
On a proxy, a person names someone they trust to act on their behalf in the event of a serious injury or illness. It may work together with a living will, but it can also stand on its own.
Most states give people the flexibility to decide which medical decisions they want to delegate to their representative on the proxy.
Below, we describe legal considerations, how to set about choosing a representative, and more.
A healthcare proxy is a legal document that someone uses as part of advance care planning, as the National Institute on Aging explain. Another name for this document is a “durable power of attorney for healthcare.”
Its purpose is to nominate someone to make one’s healthcare decisions in the event of an illness or injury. Other names for the person nominated include: proxy, agent, surrogate, or representative.
A healthcare proxy is one type of advance directive, and a living will is another. Advance directives are ways for people to express their wishes in the event that they cannot communicate them.
A healthcare proxy takes effect when a doctor determines that the person cannot make their own healthcare decisions.
At that point, the person’s healthcare representative steps in. They make medical decisions based on the preferences expressed in the proxy. This might involve choosing from a range of treatment options.
When the person can once again make these decisions, the representative stops acting on their behalf.
A person can change an advance directive, including a proxy, at any time.
Ideally, a person with a healthcare proxy explains their treatment preferences to their representative in advance. Also, the discussion might include preferred steps to extend life and efforts to prioritize the quality of life.
In addition, the person with the proxy might do some research and describe their preferences regarding the need for:
- mechanical ventilation
- tube feeding
- palliative or comfort care
A living will
An individual might put their healthcare preferences in writing by creating a living will.
A living will typically applies when a person is nearing the end of their life or is permanently unconscious.
By contrast, most states allow someone nominated on a proxy to step in when the person becomes incapacitated, not just in end-of-life situations, according to the National Hospice and Palliative Care Organization (NHPCO).
A person might just have a proxy or also have a living will. A proxy may be the right choice for someone who does not want to put specific healthcare preferences into writing.
Generally, a person can appoint anyone aged 18 or older as a healthcare representative. They may be a:
- family member
- clergy member
Although laws vary by state, the healthcare representative is typically not the person’s doctor or another medical staff member.
Many states also allow a person to name a second representative to serve as a backup if the first cannot carry out their responsibilities.
Also, states usually allow people to decide how much authority to give their representatives and what decisions they can and cannot make.
Many states have their own healthcare proxy forms. Having a lawyer involved is unnecessary, but a person might ask one for help.
States often require one or more witnesses to sign the proxy. Typically, a witness should not be a family member, the representative named on the proxy, a healthcare provider, or anyone named in the person’s will.
Some states recognize advance directives from other states, but the NHPCO recommend that anyone who spends a lot of time in more than one state prepare advance directives in each.
A healthcare proxy allows a representative to make healthcare decisions, but a different document empowers someone else to handle a person’s finances.
A power of attorney document deals with financial decisions. It allows the named individual to handle financial matters for someone who is incapacitated.
A person might decide to give this financial representative the power to manage medical payments or change health insurance plans.
It is possible to nominate the same person to make financial and healthcare decisions, but states generally require two separate documents.
Medicare Part B covers advance care planning as part of a person’s annual wellness visit.
There is no cost for the planning when it is part of the wellness visit.
A healthcare representative, the person named on the proxy, usually has access to the medical records of the person they are representing.
A person can also send Medicare an authorization form that will allow others to view their health information. This authorization remains in place until the person says in writing that they would like to reverse it.
Before nominating a representative, it is a good idea to discuss the responsibilities with them, to make that they are comfortable taking on the role.
According to the NHPCO, a good representative is someone:
- who really understands the person being represented
- who is able to stay calm in stressful situations
- who is unafraid to question doctors and will advocate for the person’s preferences
- who is good at communicating with others, including family members
Anyone who would like assistance with a proxy or another advance directive should contact:
- their state attorney general’s office
- their state department of health
- the NHPCO
- a local hospital
- their state bar association
A person uses a healthcare proxy to ensure that their medical preferences are carried out if they are ever unable to communicate due to illness or injury.
Creating this document can be an important step for adults of any age.
Considering the options and nominating a capable representative can ease pressure on friends and family members in a medical emergency.