Health Care Power of Attorney

A Health Care Power of Attorney (HCPOA) is a document that appoints someone else to make decisions regarding your medical care -- should you be unable to make the decision(s). This document might also be called a health care proxy or agent or surrogate or a medical care power of attorney. It's sometimes referred to as a Durable Power of Attorney for Health Care; "durable" meaning that it is effective even if you become incapacitated or mentally incompetent.

If your health declines to a point where you cannot communicate with others, the person named in your health care or medical power of attorney will communicate for you to your doctors and other health care providers.

Some people confuse a HCPOA with a Living Will. Both Living Wills and Health Care Powers of Attorney are considered "Advance Health Care Directives" because you are giving instructions on what you'd want to happen in the event that you become unable to make health care decisions in the future.

However, a living will is more limited because it does not give an agent the power to make medical decisions for you. Rather, a living will documents what kinds of life-sustaining procedures or treatments you would want -- or not want -- at the end of your life. This is discussed more at living will in estate planning. Some states have a document called an "Advance Health Care Directive" which combines elements of both a Health Care Power of Attorney and a Living Will.

Reasons for a Health Care Power of Attorney

Preparing a HCPOA lets you control, to some degree, the health care you'll receive if and when you're unable to communicate because you get to choose the person who will make the decisions. You will also be able to tell him or her ahead of time what your wishes would be in various situations. The person named in your HCPOA is usually referred to as your agent.

Choosing Your Medical Agent

Of course you need to choose someone you trust. You should be sure the person is willing to do it and also will have the time to handle the communications that may be necessary arranging and advocating for your health care. This person should know your religious beliefs and/or values and be able to talk to your doctor and generally act on your behalf. Your agent (also called proxy, representative, or surrogate) should be focused, not so much on what he or she thinks is the right decision, but more on making the decision that he or she thinks you would have made.

It's certainly a good idea to name an alternate agent who can step in if for some reason your primary agent is unable to serve. Due to concern about conflicts of interest, most state laws prohibit your medical provider and its employees from being named as your health care or medical agent.

Things Your Medical Power of Attorney Should Cover

Even though you trust your agent, it is still helpful to document some basic things in the HCPOA. This helps everyone to be sure your wishes are being complied with. Among other things your durable medical POA should address:

• Any medical treatments you have a religious objection to;
• Whether you want aggressive health care ("life-sustaining procedures") if you have a lengthy, chronic, terminal illness or become permanently comatose; and
• Whether you want to be resuscitated if you have an illness that causes severe mental illness like dementia.

Preparing a HCPOA

Every state has its own laws about how to prepare a POA effective in that state. There are some organizations that can provide you with a free medical power of attorney form. Of course, you can also have an attorney prepare it (never a bad idea) or do it on-line with a service like:

Terminating an HCPOA

Because a health care or medical power of attorney is durable, it is normally effective indefinitely. However, you can revoke it at any time (as long as you are legally competent) and also you could set a specific termination date in the document. To revoke an indefinite/durable POA, you should notify your agent as well as your health care provider. Also, in some states, if you name your spouse as agent, then a divorce automatically revokes the POA.

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