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health care agent is a person you choose in advance to
make health care decisions for you in the event that you become unable to do
so. A health care agent can help make medical decisions on your behalf at the
end of life or any other time you are not able to communicate, such as if you
are severely injured in an accident. A health care agent also may be called a
health care proxy or surrogate or an attorney-in-fact.
vary regarding the specific types of decisions health care agents can make.
In general, a health care agent can agree to or refuse treatment and can
withdraw treatment on your behalf. Your health care agent can use the
information in your
living will (also called a treatment directive),
statements made by you in the past, and what he or she knows about you
personally to make these decisions. For example, your agent can consent to
surgery, refuse to have you placed on life-support machines, or request that
you be taken off life support.
someone you trust. Your agent needs to be willing and able to make potentially
difficult decisions about medical treatment for you. Discuss your desires,
values, fears, and preferences about medical care in various situations. The
more your agent knows about you and your values, the more likely he or she will
be to make the kinds of decisions you would make if you were able.
Where can I get the form I need to name my health care agent?
A legal form, usually called a
medical power of attorney (but it may be called by other names in some states),
is used for documenting your choice of a health care agent. This form is
usually available through your state's bar association or office for the aging. Law offices and hospitals also have these forms or can direct
you to where to find them. You can also get copies of the forms for your state
from Caring Connections at its website or by phone: www.caringinfo.org
You must sign the form to make it
valid. Some states require the form to be notarized (witnessed by a notary
public) and signed by at least two witnesses. A medical power of attorney and a
living will are types of
advance directives. Be sure to tell your family
members and doctors whom you have selected as your health care agent.
By appointing a health care agent, you are clearly stating
who has the authority to make health decisions on your behalf. If you do not
have a health care agent or a living will, your family members may disagree
about the type of medical care you should receive if you are ever in a
situation where you cannot communicate. Depending on the state in which you
live, decisions about your medical care may be made by doctors, hospital
administrators, or judges. Completing a living will and choosing a health care
agent can help your family and friends make decisions during a stressful time.
Learning about choosing a health care agent:
Finding the right agent:
Someone will have
to make medical decisions for you if you become unable to communicate or lose
decision-making abilities. By selecting a
health care agent in advance, you grant the person you
want to make these decisions the legal right to do so. This helps avoid
uncertainty, conflict, and stress for your loved ones during a time that is
likely to already be difficult for them. Also, it ensures that you will have an
advocate to help others understand your preferences. The legal form that states
your choice of a health care agent is usually called a medical power of
attorney or a durable power of attorney for health care. But it may be called
by other names in some states.
Ideally, you will also create a
living will that outlines the basic types of care you
would want under a variety of situations. Having this document can help your
health care agent, doctors, and family members understand your desires more
completely. But it cannot cover all possible situations that might occur.
A health care agent becomes especially valuable if your condition changes. He
or she can talk to your doctors about care options, weigh the risks and
benefits, and make decisions based on the specific situation. The health care
agent and living will complement each other so you can be assured that your
medical care matches your preferences as closely as possible.
health care agent can also have more credibility in seeking a second opinion or
when talking to hospital administrators about your care. This can become
especially important if your agent feels that decisions about your health care
are not being made in the way that you would wish.
If you do not
health care agent or a living will, decisions about
your medical care may be made by family members (who may find it difficult to
be in such a position or who may disagree with each other), doctors, hospital
administrators, or judges. By appointing a health care agent, you are clearly
stating who you think understands your wishes best and who you want to make
health decisions on your behalf.
A medical power of attorney and
a living will are types of
advance directives. For more information about these
documents, see the topic
Writing an Advance Directive.
health care agent is an important decision that will
help ensure that your wishes for medical care will be respected if you are not
able to speak for yourself. The following steps will help you choose and then
prepare your agent for speaking on your behalf.
Talk with your family about
whom you have selected as your
health care agent and explain the reasons why. Try to
openly discuss the types of medical care you would or would not want under
various circumstances. Make it an ongoing conversation. You may decide to first
introduce the idea by bringing up the fact that you have selected an agent. If
your family has difficulty discussing the issue, provide more information
Make sure your
advance directive forms are kept in a safe but
accessible place, such as in your desk with other important papers. Let your
loved ones know where you keep your forms. Give copies to:
Do not keep
your advance directive forms in a safe deposit box. If you are not able to communicate, your
family may not know how to access these forms. Also, don't rely on your lawyer to
be able to provide the documents when they are needed. Your family may not know
whom to contact.
You can make changes to any advance directive at
any time. This includes changing your health care agent. You should fill out a
new form for any changes except very minor ones, such as a new phone number or
Communicate with your health care agent. If you change
your mind about medical care matters and make a new living will, keep your
health care agent up to date.
For more information on living wills
and medical powers of attorney, see the topic
Writing an Advance Directive. For more information on
other end-of-life issues, see the topics
Hospice Care and
Care at the End of Life.
Other Works Consulted
Arnold R (2012). Care of dying patients and their families. In L Goldman, A Shafer, eds., Goldman’s Cecil Medicine, 24th ed., pp. 9–15. Philadelphia: Saunders.
Cordts GA, et al. (2007). Care at the end of life. In LR Barker et al., eds., Principles of Ambulatory Medicine, 7th ed., pp. 192–207. Philadelphia: Lippincott Williams and Wilkins.
Emanuel EJ, et al. (2008). Palliative and end-of-life care. In AS Fauci et al., eds., Harrison's Principles of Internal Medicine, 17th ed., vol. 1, pp. 66–80. New York: McGraw-Hill.
Kinzbrunner BM, Gomez D (2011). Advance directives and CPR at the end of life. In BM Kinzbrunner, JS Policzer, eds., End-of-Life Care, 2nd ed., pp. 521–539. New York: McGraw-Hill.
ByHealthwise StaffPrimary Medical ReviewerAnne C. Poinier, MD - Internal MedicineSpecialist Medical ReviewerShelly R. Garone, MD, FACP - Palliative Medicine
Current as ofFebruary 20, 2015
Current as of:
February 20, 2015
Anne C. Poinier, MD - Internal Medicine & Shelly R. Garone, MD, FACP - Palliative Medicine
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