Health Care Power of Attorney

Living wills are designed to tell people who are responsible for your care what you would want done in a life-or-death situation. A similar, but different, way to have decisions made on your behalf is by identifying someone to speak on your behalf. This person is called a health care agent (or sometimes a health care proxy, attorney-in-fact for health care, or surrogate). The power they receive to represent your health care decisions comes in the form of a document called a “health care power of attorney.” It is sometimes called a “durable power of attorney for health care,” “health care proxy,” or “medical power of attorney.” The health care proxy is activated if you are unable to make health care decisions if you are seriously, but not terminally, ill, or temporarily incapacitated. This individual is charged with ensuring that you get the type of medical care you would want to receive.

Considering Your Options

Give careful thought to whom you would want as a health care proxy. In fact, give consideration to more than one person. You may need to have an alternate named who can step in if the first person you designate is not available at the time of need, or cannot serve for any reason.

You can use your health care power of attorney to spell out as many contingencies as you would like your family and doctor to know. Some thoughts you might want to express could include:

  • Conforming to religious dictates in extreme medical care situations

  • How and when you would want hospice involved in your care

  • Your preference for being allowed to die at home if at all possible

  • Whether you want to refuse a treatment even if it would hasten your death

  • Whether to prolong life through tube feeding or hydration

Quality of life issues can be addressed in your health care power of attorney document. If you were to suffer a severe brain injury — in a car accident, for example — which you might survive but with the loss of all ability to move, eat, or even breathe on your own, your health care directive could offer instructions for no heroics in saving your life.

Not all decisions for a health care proxy are life or death. A person who becomes paralyzed as a result of a stroke or an accident may need an advocate who can communicate decisions approving which tests should be done, what kinds of treatments to try, or where to do rehabilitation therapy.

Questions of sustaining life with tube feeding when there is no hope of recovery from an injury or illness can be spelled out. It is a lot to think about. You owe it to yourself and your family to have the difficult discussions on these topics so that everyone understands what choices need to be made in the event it becomes necessary.

Persistent Vegetative State

Some states permit a health care power of attorney to go into force if you slip into a persistent vegetative state. Sometimes referred to as “eyes-open unawareness,” this is when a person no longer can communicate or understand what is going on around her. It can be heart-wrenching for family members to think the person is no longer there. Better to have made some comment when you are competent about your wishes in this unlikely eventuality.

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