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Your Health Care Proxy

What is a Health Care proxy, and how can it benefit the individual?

A health care proxy is a legal document empowering a designated agent to make health care decisions on behalf of an individual in the event that he or she is unable to do so due to a medical emergency. Typically, the agent is a family member, spouse, or close friend who understands the individual's moral and ethical positions, and with whom emergency health care preferences have been directly discussed. In the event that the individual is incapacitated, the agent can legally make decisions involving all medical care, including end-of-life issues such as the application of life support.

Why Should An Individual Designate a Health Care Proxy?

When an individual becomes unable to make and/or communicate decisions for him or herself, the responsibility falls on others. In the absence of a designated agent, this responsibility is generally borne by the individual's family. While this transfer of responsibility is widely recognized, it may not be legally supported in all cases and jurisdictions. Further, the individual may not share relevant values and preferences with his or her family. Typically, hospitals and/or localities will have policies establishing procedure in such cases, but the presence of a health care proxy establishes a legal position, and guarantees that the agent is the person responsible for health care decisions.

Choosing a Health Care Agent

The agent designated by the health care proxy document should be someone whom the individual trusts to make treatment decisions consistent with his or her wishes. Further, the agent should be someone who is likely to be available to make such decisions in the case of an emergency. For these reasons, the typical agent is a family member or spouse, but can be anyone who agrees to serve in the capacity. The agent's consent should be well-informed, and he or she should understand the type of decisions that an agent may be called upon to make. It is advisable to establish a clear set of wishes with one's agent.

Responsibilities and Powers of a Health Care Agent

Fundamentally, the powers of an agent begin and end with decision making regarding care provided to the individual. The responsibilities however, are broader. Making the individual's wishes known to health care providers may require that the agent be assertive, even in cases where his or her values and personal choices might differ from those of the incapacitated individual.

Obtaining a Health Care Proxy

In the US, the requirements for designating an agent with a health care proxy vary from state to state. Some states mandate that specific forms be employed, while others simply require a written and signed agreement using language that establishes the powers of the agent. The universal requirements for creating a proxy are that the individual must be at least 18 years of age, and be mentally competent to choose an agent to act on his or her behalf. Copies of the proxy document should be readily available to health care providers, and it is advisable that the individual and agent retain copies to present in the case of an emergency.