What Is a Health Care Proxy?

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DEFINITION

A health care proxy is a legal document you use to designate someone to make choices about your care if you become incapacitated. A health care proxy is a vital tool in estate planning, even if you’ve made your end-of-life wishes clear to your family.

Key Takeaways

  • A health care proxy authorizes someone to make medical decisions for you if you become incapacitated.
  • You can choose almost any adult you trust as your health care proxy, even if they’re not a family member.
  • Typically, a health care proxy document contains instructions stating that the document becomes effective if a doctor has determined you don’t have the mental capacity to make decisions.

How Does a Health Care Proxy Work?

A health care proxy is the legal document you use to tell medical providers who should make decisions about your care if you’re not competent to do so. A health care proxy may also be referred to as health care surrogate or durable medical power of attorney.

Sometimes the term “health care proxy” refers to the person you designate rather than the legal document itself. That person may also be known as your agent or surrogate.

A health care proxy becomes necessary when a person is unconscious, cannot communicate, or their mental state has deteriorated to the point where they’re not capable of making informed decisions. If you become incapacitated and don’t have a health care proxy, your state law determines who makes medical decisions on your behalf.

Many people name their spouse or adult children as their health care proxy. However, this isn’t required. You can name anyone you trust in your health care proxy to speak for you in the event you’re not able to, even if they’re not a family member. You can also change your designation any time by filling out a new form and providing it to your family and doctor.

The rules about when the document takes effect are outlined in the document itself. A health care proxy becomes effective when a physician determines you can’t make decisions on your own. Until then, you’re in control of your own medical decisions. 

The person you name in your health care proxy will be able to:

  • Authorize medical care and surgical treatments.
  • Have first priority for hospital visitation.
  • Receive your personal belongings from a hospital or police agency.
  • Access your medical records.
  • Request a specialist or second opinion.

Some states allow you to name more than one proxy. But this typically isn’t recommended, as the situation can get complicated if the parties disagree on treatment. However, it’s a good idea to name an alternate proxy, provided your state allows it. That person can step in if your primary proxy dies or becomes incapacitated.

Example of a Health Care Proxy

For example, suppose you name your sister as your proxy. You’d want to discuss your wishes with your sister and tell her where you keep the document. You’d also want to provide a copy to your physician. But as long as you remain competent, your sister has no authority over your health care.

Suppose a car accident leaves you in a vegetative state. You’re unconscious, so you can’t give instructions for your care. The health care proxy would go into effect, giving your sister authority to make decisions for you.

A health care proxy is different from power of attorney. A health care proxy appoints someone to make medical decisions, whereas power of attorney authorizes a person to make financial decisions.

Health Care Proxy vs. Living Will

Health Care Proxy Living Will
Specifies who can make health care decisions for you if you’re incapacitated Gives specific instructions for your care if you’re unable to communicate
Used not just for end-of-life care, but also in situations where you’re incapacitated Typically used when you have a terminal illness or injury

Health care proxies and living wills are both legal estate-planning documents known as advance directives. Each provides instructions for your medical care in case you can’t express your wishes. While a health care proxy designates someone to make decisions for you, a living will provides instructions for your care. For example, you may use a living will to state whether you want CPR if your heart stops beating or if you’d want to be connected to a ventilator

Living wills are typically used to determine end-of-life care for someone who’s terminally ill or injured. However, powers of attorney have a broader use, since they usually become effective when someone lacks mental capacity to make decisions. Although a living will can inform health care providers about your wishes, it’s impossible to give instructions for every scenario. That’s why you may want a health care proxy even if you have a living will.

How Do I Get a Health Care Proxy?

Even if you’re young and don’t have medical issues, it’s a smart move to designate a health care proxy for a worst-case scenario. Think about who you’d want to speak for you if you weren’t able to. Also consider whether the person can make difficult decisions quickly and if you think they’d ask questions and seek clarification from health care providers to make sure your wishes are followed.

You can name almost anyone you choose as your health care proxy, with a few exceptions:

  • They must be at least 18 (or 19 in Alabama and Nebraska)
  • They can’t be an employee of a health care facility where you’re a patient, unless they’re your relative. They can’t be your current doctor, nurse or any other member of your health care team
  • In more than half of states, they can’t be a potential beneficiary of your estate or someone who is financially responsible for your care

The rules for health care proxies vary by state, but some require you to sign forms with witnesses present. But even if you haven’t filled out your state’s form, doctors are still legally required to follow any wishes you’ve clearly communicated. 

You can use the AARP’s free advance directives forms tool, which will guide you to health care proxy forms for your state. Keep in mind, though, that it’s always best to consult with an attorney about estate-planning issues.

Finally, even if you have a health care proxy and living will, it’s essential to discuss your wishes with your doctor. Make sure they understand the type of medical care you’d want if you became incapacitated or terminally ill, that they’re willing to comply with your instructions, and that they document your wishes.

Frequently Asked Questions (FAQs)

Who can serve as a health care proxy?

You can name any person over the age of 18 (19 in Alabama and Nebraska) in your health care proxy. The adult you name in your health care proxy doesn’t have to be a family member, but in some states they cannot be named as a beneficiary or financially responsible for your care.

Is your spouse automatically your health care proxy?

If you haven’t designated a party in your health care proxy, medical professionals will often turn to your family for guidance on handling your healthcare. The spouse of the incapacitated person is generally turned to first, but the person named in the health care proxy can override the spouse.



Article Sources

  1.  Institute for Healthcare Improvement. “How to Choose a Health Care Proxy."

  2. Institute for Healthcare Improvement. “How to Choose a Health Care Proxy,” Page 7.