Health care proxy

What it means

A health care proxy appoints a person. It does not say what should be decided — that is what a living will does — and the two are usually signed together, sometimes on one form.

It takes effect only when the person cannot decide for themselves, and the treating clinicians make that determination.

The names differ by state: health care proxy, health care power of attorney, medical power of attorney, appointment of health care agent. They are the same idea.

Why it matters

Without one, clinicians turn to a state's default list of who may decide — usually a spouse, then adult children — which may not be the person the patient would have chosen, and can leave several people with equal standing and no agreement.

It also spares the family the worst version of the conversation: deciding under pressure, without knowing what was wanted, and without knowing who is allowed to say.

When you are likely to meet it

• When a parent is admitted to hospital.
• When organizing documents before a planned operation.
• When a clinician asks who is the decision-maker.

How this varies by state

What the document is called, whether it must be witnessed or notarized, and who decides by default when nobody has been appointed, are all set by state law.

Related terms

• Advance directiveA document recording your medical wishes, and naming who should speak for you if you cannot.
• CapacityWhether somebody is able to understand a decision and its consequences well enough to make it. It is decided decision by decision, not once and for all.
• DeclarantThe person who signed the advance directive — named this way because the document speaks for them once they cannot.
• Do-not-resuscitate orderA medical order saying that if the heart or breathing stops, no attempt at resuscitation should be made.
• Domestic partnerA legally registered relationship short of marriage. Whether it carries inheritance rights depends entirely on the state.
• Durable power of attorneyA power of attorney that keeps working after the person who signed it loses the ability to make decisions — which is usually the whole point of signing one.
• Health care agentThe person named in a health care proxy to make medical decisions when the patient cannot.
• HIPAA authorizationWritten permission for a doctor, hospital or insurer to share somebody's medical information with a named person.
• Living willA written statement of what medical treatment you would and would not want if you could not say so at the time.
• POLSTA medical order form covering more than resuscitation, signed by a clinician, meant to travel with the patient between home, hospital and care facility.

Sahvelo guidance that uses this

• Advance directives