What Is a Health Care Proxy and Do You Need One?

Who would decide what was best for you? Who would advocate on your behalf?

Posted Oct 18, 2017

What is a Health Care Proxy?

Below is the definition from www.medicinenet.com:

Health care proxy: An advance medical directive in the form of a legal document that designates another person (a proxy) to make health care decisions in case a person is rendered incapable of making his or her wishes known. The health care proxy has, in essence, the same rights to request or refuse treatment that the person would have if he or she were capable of making and communicating decisions.

It’s not something we like to think about, but what would happen in the event of a medical emergency if you became incapacitated and could not speak for yourself? Who would decide what was best for you? Who would advocate on your behalf? 

In most cases, this would be your spouse or a parent (guardian) if you are a minor under the age of 18 years old. However, if you are over 18 years old and not married, did you know that your medical condition, treatment options, and health care plan cannot be shared with anyone, even a family member, unless they are your health care proxy? Further, a doctor, medical center, hospital, EMT, and even assisted living staff can make decisions regarding your healthcare, treatment methods and type of medical care to provide you if you are not married, over 18 years old, and do not have a health care proxy in place.

I thought this information was very important to share since learning about my patients’ experiences. 

with permission from Dr. Diane site
Source: with permission from Dr. Diane site

Recently, a patient’s son who had just turned 18 years old was rushed to the local hospital for emergency treatment. He was not able to speak on his own behalf. He lives with his mother, who was present at the hospital. She asked the doctor about her son’s condition. The doctor told my patient that he cannot discuss her son’s condition with her unless she was his Health Care Proxy. Her reaction was, “I’m his mother! I want to know if my son is ok and what are you doing to him.” The doctor calmly explained that her son was now an adult, and even though she was his mother, unless she was his health care proxy, he was not allowed to share any information. My patient was very upset. Understandably. She cried and pleaded with the doctor, explaining her son just turned 18 years old earlier in the week. Yet, he refused to give any information.

Her son regained consciousness later that day and signed a note allowing his mother to be privy to his medical information. She now has a proper health care proxy for all of her adult children who are over 18 years of age. Once I heard about this experience, I quickly did the same with my adult children, yet had not thought about my own situation. I was married for 35 years and my husband, who is a medical doctor, was my health care proxy, and I his, that is, until we divorced.  Suddenly, I had to decide who I would choose to make medical decisions on my behalf.  

I realized that with my medical condition, it had to be someone who understood my condition, my philosophy about life and healthcare, along with knowing my long list of allergies to medications and foods.

Another one of my patients, who had a concussion and lives at home with his mother, recently turned 18 years old. I asked him if he knew that he needed a health care proxy to make medical decisions for him if he was knocked unconscious and was unable to speak on his own behalf. As many believe, he thought his mother could make these decisions for him. I explained to him that this was not the case. He wondered why his primary care physician never discussed this with him. I wondered too, never having been asked that by my own doctor. I am making it a point to discuss this very important topic with my own patients and clients. It is easy to fill out the necessary form. It may be harder for some to decide who the appropriate and willing person should be to trust with the quality of your life.

Choose Your Health Care Proxy Wisely

When choosing someone to be your “voice” there are many factors to consider.  Make sure your emotional connection to this person will not impact their ability to make decisions on your behalf, even if they don’t agree with your wishes. Be sure this person is confident and comfortable to be able to speak to doctors, and other medical staff and will ask for clarification if they do not understand what is happening. They could be making decisions about life-saving procedures, as well as consent for treatments, surgery, blood transfusions, pain medications, and diagnostic tests. The person you appoint as your health care proxy should be someone who truly knows what decisions you would make for yourself. You are granting them a major responsibility.

Health Care Proxy Responsibilities Could Include:

  • Deciding on medical care, including medical tests, medication, or surgery
  • Requesting or declining life-support treatments
  • Authorizing or refusing medication, procedure, and pain management
  • Choosing which hospital, medical facility, nursing home, or hospice is best
  • Understanding and asking questions about your condition, and available treatment options
  • Reviewing your medical history/chart
  • Communicating with your family members about your condition and treatment plan
  • Requesting second opinions or alternative medical care/treatment options

Suggested Topics to Discuss

It is important for you and your health care proxy to discuss your wishes in advance, while you are able to communicate, so they know how to best advocate for you.

Here are some suggestions to discuss with your health care proxy:

  • Allergies, food/medicine, other
  • Chronic Conditions, any ongoing medical conditions
  • Previous surgeries, when/why
  • Current Medications, when/why
  • Medical treatments that you would prefer not to receive, why
  • End of life wishes
    • Life-support treatments that you would or would not like to receive
    • What your feelings are regarding mechanical breathing (respirator), cardiopulmonary resuscitation (CPR), artificial nutrition and hydration, hospital intensive care, pain management, chemo or radiation therapy, and surgery
    • Would you want antibiotics if you developed a life-threatening infection
    • Would you prefer to remain at home if possible, or be in a hospital or hospice environment
    • Any religious or spiritual wishes
  • Life-support treatments that you would or would not like to receive
  • What your feelings are regarding mechanical breathing (respirator), cardiopulmonary resuscitation (CPR), artificial nutrition and hydration, hospital intensive care, pain management, chemo or radiation therapy, and surgery
  • Would you want antibiotics if you developed a life-threatening infection
  • Would you prefer to remain at home if possible, or be in a hospital or hospice environment
  • Any religious or spiritual wishes

There are many resources available to help you and your health care proxy develop a care plan. These are merely suggestions to get you thinking about possible scenarios and topics to discuss. I hope you found this blog informative, and urge you to share it with anyone who does not have a health care proxy. We always think it will never happen to us, but what if it does? It's best to be prepared! 

Dr. Diane Roberts Stoler, Ed.D.

Copyright (c) October 2017