Health care proxies and advance directives are two legal tools that you have at your disposal to help determine what happens to you and how much or how little is done for you when you are no longer able to make medical treatment decisions yourself.
In Massachusetts, under the Health Care Proxy Law (Massachusetts General Laws, Chapter 201D), any competent adult 18 years of age or over may appoint a Health Care Agent. You (known as the “Principal”) can appoint any adult EXCEPT the administrator, operator, or employee of a health care facility such as a hospital or nursing home where you are a patient or resident UNLESS that person is also related to you by blood, marriage, or adoption. This person should be someone you know and trust to make health care decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions. The Health Care Proxy is an important document, however, because it concerns not only the choices you make about your health care, but also the relationships you have with your physician, family, and others who may be involved with your care.
It’s important to discuss your wish to appoint this person as your health care agent with him or her before doing so. Obviously, it is not a responsibility to be taken lightly and the person should not only be willing and able to accept it, but should have a very clear understanding of your wishes concerning your medical care.
Your Agent will make decisions about your health care only when you are, for some reason, unable to do that yourself. This means that your Agent can act for you if you are temporarily unconscious, in a coma, or have some other condition in which you cannot make or communicate health care decisions. Your Agent cannot act for you until your doctor determines, in writing, that you lack the ability to make health care decisions. Your doctor will tell you of this if there is any sign that you would understand it. Acting with your authority, your Agent can make any health care decision that you could, if you were able. If you give your Agent full authority to act for you, he or she can consent to or refuse any medical treatment, including treatment that could keep you alive. Your Agent will make decisions for you only after talking with your doctor or health care provider, and after fully considering all the options regarding diagnosis, prognosis, and treatment of your illness or condition. Your Agent has the legal right to get any information, including confidential medical information, necessary to make informed decisions for you. Your Agent will make health care decisions for you according to your wishes or according to his/her assessment of your wishes, including your religious or moral beliefs. You may wish to talk first with your doctor, religious advisor, or your family/close friend before giving instructions to your Agent.
An advance directive is a document you develop based on the principles of your right to die and to die with dignity. It is essentially your guide to how you want to be treated and the tool that will assist your Agent in determining your treatment. Advance directives are not just for the elderly. All people who desire to direct their medical care in the future should complete an advance directive.
It’s important to note that an advance directive does not mean “do not treat.” This is a common misperception. Of course, if you want it to mean do not treat, then that is something that your Agent needs to know.
With a little foresight, proper planning, and the right legal documents in place, a health care proxy and advance directive can provide you and your loved ones with valuable peace-of-mind in the event that you become unable to make the difficult decisions about your medical care on your own.