Health Care Agents

Why Have a Health Care Agent?

When you are unable to speak for yourself due to an illness, your health care providers may be unclear as to what type of care you would like.

Your family members may be uncertain or disagree about the type of medical care you should receive. Decisions about your medical care may then be made by doctors, hospital administrators, a court-appointed guardian, or judges.

A health care agent, chosen by you, can help your providers, family, and friends make decisions during a stressful time.

Your agent's duty is to see that your wishes are followed. If your wishes are not known, your agent should try to decide what you want.

Health care agents are not required. But they are the best way to be sure your wishes for health care treatment are followed.

What Can a Health Care Agent Do?

If you have an advance directive also called a living will, your health care agent can make sure your wishes are followed. Your agent's choices come before anyone else's wishes for you .

If you do not have a living will or an advanced directive, your health care agent will be the one to help your health care providers make important choices.

Your health care agent has no control over your money. Your agent also cannot be made to pay your bills.

What a health care agent can and cannot do differs by state. Check your state laws. In most states, health care agents can:

• Choose or refuse life-sustaining and other medical treatment on your behalf
• Agree to and then stop treatment if your health does not improve
• Access and release your medical records
• Request an autopsy and donate your organs, unless you have stated otherwise in your advance directive

Before you choose a health care agent, you should find out whether your state allows a health care agent to do the following:

• Refuse or withdraw life-enhancing care.
• Refuse or stop tube feeding or other life-sustaining care. Even if you have not stated on your advance directive that you do not want these treatments.
• Order sterilization or abortion.

Choosing Your Health Care Agent

Choose a person who knows your treatment wishes and is willing to carry them out. Be sure to tell your agent what is important to you.

• You can name a family member, close friend, minister, priest, or rabbi.
• You should name only 1 person as your agent.
• Name 1 or 2 other people as backups. You need a backup person in case your first choice can't be reached when needed.

Talk to each person you are thinking of naming as your agent or alternate. Do this before you decide who should carry out your wishes. Your agent should be:

• An adult, 18 years or older
• Someone you trust and can talk to about the care you want and what is important to you
• Someone who supports your treatment choices

In many states, your agent cannot be:

• Your doctor or another provider
• An employee of your doctor or of a hospital, nursing home, or hospice program where you receive care, even if the person is a trusted family member

What You Need to Do

Think of your beliefs about life-sustaining treatment, which is the use of equipment to prolong your life when your body organs stop working well.

A health care proxy is a legal paper that you fill out. You can get a form online, at your doctor's office, hospital, or senior citizen centers.

• In the form you will list the name of your health care agent, and any backups.
• Many states require witness signatures on the form.

A health care proxy is not a living will. A living will is a written statement that can include your health care wishes. Unlike a living will, the health care proxy allows you to name a health care agent to carry out those wishes if you cannot.

You can change your mind about health care choices at any time. If you do change your mind, or if your health changes, talk to your doctor. Be sure to tell your health care agent about any changes in your wishes.

References

Fabiny A, Sabatino C. Living Wills: A Guide to Advance Directives, the Health Care Power of Attorney, and Other Key Documents. Cambridge, MA: Harvard Health Publications; 2013.

Rakel RE, Trinh TH. Care of the dying patient. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 5.

Zorowitz RA. Ethics. In: Ham RJ Jr, Sloane PD, Warshaw GA, et al, eds. Ham's Primary Care Geriatrics: A Case-Based Approach. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 7.