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A health care proxy, or health care proxy form, is a legal document that allows
a person to choose someone to make medical decisions on their behalf when they
are unable to do so. In some states the person who is authorized may be called a
proxy; in others the person may be called an agent.
Description
A health care proxy form is part of a set of legal documents
that allows a person to appoint someone to make medical decisions for them if or
when they cannot act on their own behalf, and to make sure that health care
professionals follow their wishes regarding specific medical treatments at the
end of life. These documents are referred to as advance directives. The document
naming the person appointed to make the decisions is called a health care proxy.
The document that lists acceptable and unacceptable measures of
artificial life support is called a living will. Most states have passed laws
that authorize people to draw up living wills, but it is important to get
specific information about the laws in ones own state. Any competent adult can
appoint a health care proxy or agent. It is not necessary to hire a lawyer to
draw up or validate the form; most states, however, require two adult witnesses
to sign a proxy form. Many hospitals provide proxy forms on request.
It is important to have a health care proxy in order to be able to choose the
person who will be making medical decisions on ones behalf. In addition to
naming the specific person who will make those decisions, one should think about
what life-sustaining treatments one would be willing to undergo in the event of
a medical emergency or terminal illness.
A health care proxy form does not deprive a personof the right to make
decisions about medical treatment as long as he or she is able to do so. It is
put into effect only when the patients health care team determines that the
patient is unable to make decisions on his or her own. For example, a person may
be in a coma following an automobile accident. The physician would document in
the patients medical record that the patient is unable to make his or her own
medical decisions; the circumstances that led to the patients present
condition; the nature of the disease or injury; and the expected length of the
patients incapacitation.
The person named as proxy makes health care decisions only as long as the
patient is unable to make them for him- or herself. If the person regains the
ability to make his or her own decisions, the proxy will no longer make them. If
the incapacitation is permanent, the proxy will continue to make health care
decisions on the patients behalf as long as the patient is alive, or until the
proxy is no longer able to carry the responsibility. Any trusted adult can be
named as a health care proxy. Most married people name their spouse, but it is
not necessary to do so. In addition, it is important to select an alternate
proxy, in the event that the person first named is unable to fulfill the
responsibility.
For example, if the spouse has been named as proxy, and
both members of the couple were incapacitated in a house fire, then someone else
should be empowered to act on their behalf. A married couple does not need to
name the same individual as a proxy or as the alternate. It is best to choose
someone who lives close enough to carry out the responsibilities of a proxy
without having to travel across state lines. One should consider whether a
potential proxy will be able to ask the necessary questions of medical personnel
in order to obtain information needed to make a decision. It is important to
discuss with the proxy his or her own value system, and whether he or she could
make a decision for someone else that he or she would not make for him- or
herself. It is a good idea to carry the name and contact information of the
proxy in ones wallet in the event of an emergency or sudden incapacitation.
The purpose of a living will is to give specific instructions about emergency
or end-of-life health care. In some states a living will may be part of the
health care proxy document. But because it is impossible to plan for all
possible situations, the health care proxy can interpret ones wishes to members
of the health care team and make decisions that one could not foresee at the
time of making a living will. This is why it is important for the proxy to
understand ones value system, so that the proxy can use his or her judgment as
to what one would want.
The proxy should be given a written copy of all advance directives. Even if a
living will is not legal in the state in which one resides, writing such a will
is an opportunity to think through ones beliefs and health care preferences.
The proxy or agent can then can use the living will as a guide in making health
care decisions as need arises.
Completing a health care proxy form and living will is useful because it
helps one to think through ones value system and ones definition of quality of
life. Some areas to consider are:
• What makes my life meaningful?
• What
religious or personal beliefs do I hold that affect my health care
decisions?
• Do I want my proxy to make health care decisions on his or her
own, or are there other people I would want him or her to consult? If so, who
are these people? Is there anyone who should not be consulted?
• Who besides
myself will be affected by these decisions? Are they aware of my value system?
Would they try to interfere with the proxys decisions?
• What do I want to
do about organ donation?
• Have I informed my physician of my wishes?
Appointing a health care proxy is not an irrevocable decision. One can change
or revoke the proxy at any time, usually by filling out a new form. In some
states, one can specify that the health care proxy will expire on a certain date
or if certain events occur. If one has named ones spouse as an agent, the proxy
is no longer in effect in the event of separation or divorce. People who want a
former spouse to continue as their agent must complete a new proxy form.
In addition to keeping a copy of the proxy form in ones own file of
important documents, one should give copies to the proxy, the alternate, and
ones physicians.
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