A healthcare proxy is a document that gives someone the power to make healthcare decisions for a person who cannot do so. People may also refer to it as a durable power of attorney for healthcare.
On a proxy, a person names someone they trust to act on their behalf in the event of a serious injury or illness. It may work together with a living will, but it can also stand on its own.
Most states give people the flexibility to decide which medical decisions they want to delegate to their representative on the proxy.
Below, we describe legal considerations, tips on choosing a representative, and more.
As the National Institute on Aging (NIA) explains, a healthcare proxy is a legal document people use for advance care planning. Another name for this document is a “durable power of attorney for healthcare.”
Its purpose is to nominate someone to make a person’s healthcare decisions in the event of an illness or injury. Other names for the nominee include proxy, agent, surrogate, or representative.
A healthcare proxy is one type of advance directive, and a living will is another. Advance directives allow people to express their wishes in the event that they cannot communicate them.
A healthcare proxy takes effect when a doctor determines that the person cannot make their own healthcare decisions.
At that point, the person’s healthcare representative steps in. They make medical decisions according to the preferences that the proxy expresses. This might involve choosing from a range of treatment options and identifying where a person will receive care. However, the responsibilities of a healthcare proxy can vary by state.
When the person can once again make these decisions, the representative stops acting on their behalf.
A person can change an advance directive, including a proxy, at any time.
Ideally, a person with a healthcare proxy explains their treatment preferences to their representative in advance. The discussion might also include preferred steps to extend life and efforts to prioritize the quality of life.
In addition, the person with the proxy might do some research and describe their preferences regarding the need for:
An individual might put their healthcare preferences in writing by creating a living will.
According to the American Bar Association, a living will applies in situations in which the decision to use life-sustaining treatments may prolong an individual’s life for a limited period, and not obtaining such treatment would result in their death.
By contrast, most states allow someone nominated on a proxy to step in when the person becomes incapacitated, not just in end-of-life situations. For example, if a person is unconscious or their mental state means that they do not have the legal capacity to make their own decisions.
A person might have a healthcare proxy instead of, or in addition to, a living will. A proxy may be the right choice for someone who does not want to put specific healthcare preferences into writing.
Generally, a person can appoint anyone ages 18 or older as a healthcare representative. However, in Nebraska and Alabama, a healthcare proxy must be 19 or older. They may be a:
Although laws vary by state, the healthcare representative is typically not the person’s doctor or another medical staff member.
Many states also allow a person to name an alternate representative to serve as a backup if the first cannot carry out their responsibilities.
Additionally, states usually allow people to decide how much authority to give their representatives and what decisions they can and cannot make.
