You are putting an awful lot of faith in another person to speak for you in extreme circumstances. This is a heavy mantle of responsibility you will be asking another person to bear. Most commonly, people ask a spouse or other close relative or friend to fulfill this role for them. More important than bloodlines, however, is the degree of trust you have in this person. It must be absolute. After all, you are entrusting them with your life. This individual need not agree with all of your wishes, but you must be certain he will honor them. The only way to be assured of that is to have very frank conversations culminating with full confidence that your demands for the kind of medical treatment you want will be followed.

If you are too uncomfortable to have the conversation with your potential health care agent, you may need to consider another person, or find a way to work up your courage to open the discussion with the logical person to carry out this responsibility.

When you are considering persons to fulfill the role of health care agent, weigh the following attributes:

• Is she nearby? If you are down with an extended illness you might need someone who can be available to talk to doctors on a regular basis, making sure your wishes are being carried out.

• Will this person advocate for you? This is no job for shrinking violets.

• Can he stand up to the impenetrable medical institutions surrounding you? Can he hold the line against vehement family members who disagree with your plans?

• Is she able to communicate well with doctors?

• Do you trust his judgment?

• Does she basically agree with your views?

It is possible to name more than one person to make health care decisions for you. Even without a formal document, family members will be consulted. However, it is best to name only one health care agent, however, who will have ultimate final say on your behalf. This is not a role that lends itself to job sharing. If you have a few candidates, any one of whom would do an excellent job on your behalf, you could perhaps ask them to choose among themselves. Maybe there would be a group of you who would each do it for one another, whether it is within a family constellation or a group of friends.

In the event you have no one who can serve as your agent, you should still execute a living will and write out your preferences for the medical care you would want in circumstances where you could not speak for yourself.