Your Health Care Proxy Speaks for You when You Cannot

Health care proxies have durable power of attorney for health care decisions in case you cannot make them yourself. Give your proxy a copy of the document that grants them this power and discuss your health care situation, desires, fears and values with them before you need their help. Tell your doctors, family members, and close friends the name(s) of your health care proxy.

To be well equipped for the task, your proxy needs to know what it means to be a proxy:

1. He or she may be referred to by others as your "proxy," "agent," "attorney-in-fact," "surrogate," or "representative." The document that grants them this power is called a "Durable Power of Attorney for Health Care," sometimes shortened to "Power of Attorney" by medical professionals.
2. Duties depend on what you have written in your advance directive, as well as on state law.
3. Duties begin when you, as the patient, are unable to make decisions about health care on your own. Remember that two doctors will have to make this determination.

To help your proxy prepare, tell him or her:

1. Your thoughts and preferences about being dependent on others for help with basic needs, like bathing and dressing.
2. What makes your life worth living and what would make it unbearable.
3. Your health situation in detail.
4. How you would feel if your health gets worse; what medical interventions you would and would not want performed.
5. What the words "a good death" mean to you.
6. What you would like done with your body once you are gone.
7. Who you would like to be kept informed about your health decisions and care.

Tips for Your Health Care Proxy

As a proxy, if you need to make a decision:

1. Make sure the medical team is aware that you are the proxy decision-maker. Being an advocate on the patient's behalf may require that you be assertive.
2. Keep the advance directive with you to help legitimize your involvement.
3. If there is another proxy, build and maintain a good working relationship with him or her.
4. Learn the details of the patient's medical situation.
5. Find out what the medical options are, including all of the risks and benefits.
6. Keep key people informed, as the patient prefers.
7. Determine what the patient might have chosen if he or she had known the same facts and options:

a. If you know what the patient's preferences are, follow them.

b. If you don't know the patient's wishes, try to imagine yourself in his or her place, considering his or her values, beliefs, previous choices, and things said. Choose as he or she would have, even if it is not what you would choose for yourself.

c. If you have no idea how the patient would choose, consult with the doctors, the other proxy (if there is one) and any loved ones who can help you better understand the patient's values and preferences. Then make a decision based on the patient's best interest and the choice that a reasonable person would make in the same situation.