Choosing a Health Care Agent

Overview

What is a health care agent?

Your health care agent (health care proxy, health care surrogate) can make decisions about the kind of care you get as you near the end of your life or anytime you can't speak or decide for yourself. One example is if you are badly hurt in an accident.

In general, a health care agent can agree to or refuse treatment. An agent can also stop treatment on your behalf.

To make these decisions, your agent can use the information in your living will. Your agent can also use statements you have made in the past and what your agent knows about you. Your agent can agree to surgery. Your agent can refuse to have you placed on life-support machines. Your agent also can ask that you be taken off life support.

How do you choose a health care agent?

Choose your health care agent (health care proxy, health care surrogate) carefully. You can choose a family member or someone else. Talk to the person before you decide. Make sure the person is comfortable with this responsibility.

It's a good idea to choose someone who:

• Is at least 18 years old.
• Is someone you trust.
• Knows you well and understands what makes life meaningful for you.
• Understands your religious and moral values.
• Will honor your wishes and do what you want, not what they want.
• Will be able to make hard choices at a stressful time.
• Will be able to refuse or stop treatment, if that's what you would want, even if you might die.
• Will be assertive with doctors if needed.
• Will be able to ask questions of doctors and others to get the information needed to make decisions.
• Lives near you or will travel to you if needed.

Who will make decisions for you if you don't have a health care agent?

If you don't have a health care agent or a living will, you may not get the care you want. Decisions may be made by family members who disagree about your medical care. Or decisions may be made by a medical professional who doesn't know you well. In some cases, a judge makes the decisions.

When you name a health care agent, it is very clear who has the power to make health decisions for you.

Choosing Your Health Care Agent

Choose your health care agent carefully. This person may or may not be a family member.

Talk to the person before you make your final decision. Make sure this person is comfortable with this responsibility.

It's a good idea to choose someone who:

• Is at least 18 years old.
• Knows you well and understands what makes life meaningful for you.
• Understands your religious and moral values.
• Will do what you want, not what that person wants.
• Will be able to make difficult choices at a stressful time.
• Will be able to refuse or stop treatment, if that is what you would want, even if you could die.
• Will be firm and confident with health professionals if needed.
• Will ask questions to get needed information.
• Lives near you or agrees to travel to you if needed.

Your family may help you make medical decisions while you can still be part of that process. But it's important to choose one person to be your health care agent in case you aren't able to make decisions for yourself.

If you don't fill out the legal form and name a health care agent, the decisions your family can make may be limited.

A health care agent may be called something else in your state.

Who can be a health care agent?

For your health care agent (health care proxy, health care surrogate), you may choose:

• Your partner.
• A child or grandchild.
• Another family member.
• A close friend.
• An attorney.

Most states allow you to choose only one person at a time to be your health care agent. In most cases, your doctor cannot be your health care agent. In some states, a person who works at the health care facility where you might be treated may not be your agent, unless you are related to the person by blood or by marriage.

If your state allows, choose one or two alternate agents who can fill the role if your primary agent is not available or is not able to do so.

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Decisions a Health Care Agent Can Make

Your health care agent, also called a health care proxy or health care surrogate, can make decisions about the kind of care you get as you near the end of your life. An agent also can make decisions any other time you can't speak or decide for yourself. One example is if you're badly hurt in an accident.

State laws vary about the types of decisions health care agents can make. In general, they can agree to or refuse treatment. They can also stop treatment on your behalf.

To make these decisions, your agent can use the information in your living will (declaration). Your agent can also use statements you have made in the past and what your agent knows about you. Your agent can agree to surgery. Your agent can refuse to have you placed on life-support machines. Your agent also can ask that you be taken off life support if you made this wish clear before you became ill.

Your health care agent becomes even more valuable if your condition changes. Your agent can talk to your doctors about care options. Your agent can weigh the risks and benefits and can make decisions based on the specific situation. Your agent can also be more credible in seeking a second opinion or when talking to hospital staff about your care. This can be important if your agent feels that decisions about your health care are not being made in the way that you would wish.

If you don't have a health care agent or a living will, you may not get the care you want if you can't speak or decide for yourself. Decisions about your care may be made by family members who disagree with your wishes. Or decisions may be made by a doctor who doesn't know you. In some cases, the decision will be made by hospital staff or a judge.

In some states, hospital staff must take steps to keep you alive as long as possible if your wishes aren't known. This means you could be on life support for a long time, even if that isn't what you would want.

When you name a health care agent, it's very clear who has the power to make health decisions for you.

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What a Health Care Agent Needs to Know

Talk to your health care agent (health care proxy, health care surrogate) about your desires, values, fears, and preferences about the types of medical care you would want in different situations.

Make sure your agent knows what you think is an acceptable quality of life. Let your agent know when you would or wouldn't want treatment. This may depend on your chances for recovery.

Don't assume that someone close to you, like a child or spouse, knows what you would want. Your agent may not know about or share your preferences. So it's important to talk openly about your wishes.

It's not possible to discuss all the situations in which your agent may need to make a decision for you. But the more your agent knows about you and your values, the more likely your agent will be able to make the kinds of decisions you would make if you could.

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How to Name a Health Care Agent

You name your health care agent on a legal form. The form is usually called a medical power of attorney. Your agent and the form may be called something else in your state.

This form may be available through your state's bar association, medical association, or office for the aging. Law offices and hospitals also may have these forms or can tell you where to find them.

Read the forms carefully. Some states may limit the types of decisions that a health care agent can make. Or they may limit the health care agent's power to only those decisions written in your living will. Depending on the laws in your state, you may want to have your health care agent with you as you write your living will so that your agent understands your wishes.

You must sign the form to make it valid. You don't need a lawyer or attorney to complete this form. But it must be witnessed by someone other than you and your agent. Some states require you to get the form notarized. This means that a person called a notary public watches you sign the form. And then the notary also signs the form. States may also require that at least two witnesses sign the form.

Be sure to tell your family, your doctors, and anyone else who might be involved in your medical care who your agent is. And let them know how to contact your agent.

You can make changes to your medical power of attorney at any time. You can also choose a different person to be your health care agent.