Power of attorney for medical decisions: who decides when you cannot

What your agent can decide

When the power starts and ends

Most medical powers of attorney start when your doctor decides you cannot understand or communicate a decision. Until then, you decide for yourself.

The power ends when you recover, when you revoke it or at your death. After death, decisions about the body and the estate follow other documents.

Medical power of attorney, health care proxy and living will

Many states combine the power of attorney and the living will in one advance directive form. Others keep them separate.

How to choose your medical agent

• Someone who will follow your wishes, even if they disagree.
• Someone who can talk with doctors under pressure.
• Someone who can reach the hospital fast.
• Someone your family will accept as the decision maker.

Many states do not let your own doctor or the staff of your care facility act as your agent, unless they are family. Name a backup agent as well.

Talk to your agent before you sign

The form names the person. The conversation tells them what to do. Talk about life support, pain control, where you want to be cared for and what matters most to you.

Write the main points in the form if it has space. Your agent will read them in the hardest moment, and your words will help them decide.

What the form usually looks like

Here are the first clauses of a typical medical power of attorney. The full form, ready to fill in and sign, is on its own page.

1. 1Designation of agent. I, [principal name], of [address], name [agent name], of [address], phone [number], as my agent to make health care decisions for me.
2. 2Alternate agent. If my agent is not willing, able or reasonably available, I name [alternate name] as my alternate agent.
3. 3Authority. My agent may make all health care decisions for me, including decisions to provide, withhold or withdraw treatment, unless I state otherwise below.
4. 4When effective. This power takes effect when my attending physician determines that I lack the capacity to make my own health care decisions.

Use the medical power of attorney form

Many states publish their own advance directive form. A state form is the safest choice when your state has one.

How to sign a medical power of attorney online

Upload a medical power of attorney to SignSolú or start from a template. Add each signer with a name and a phone number or email.

Each signer gets a link by WhatsApp or email. On a phone they tap the brown bar at the bottom that says «Sign as …».

They draw their signature once with a finger and press «Sign and Send». Every place in the document that needs it gets filled.

A line next to that button records their consent to sign electronically, with a link to the disclosure.

The signed PDF ends with an audit certificate. It shows each signer, the time, the IP address and a SHA-256 hash of the file.

When the signed copy comes back, verify the PDF signature online against the original.

Many states ask for two adult witnesses or a notary on a medical power of attorney, and some say who cannot be a witness. Some accept electronic signatures and remote witnessing, others still ask for ink. Check your state form before signing.

After you sign

1. 1Give a copy to your agent and your alternate.
2. 2Give a copy to your doctor and ask to add it to your record.
3. 3Take a copy when you go to the hospital.
4. 4Review it after a marriage, divorce, diagnosis or move to another state.

How doctors work with your agent

When your agent steps in, the care team treats them as they would treat you. They explain the options, the risks and what to expect.

Under HIPAA, a person with legal authority to make health decisions for you is treated as your personal representative. That gives your agent access to the records they need to decide.

Doctors may still ask for a copy of the form and check it is signed and witnessed. Hospitals often scan it into the record so the next shift sees it.

Common mistakes

1. 1Naming someone who will not follow your wishes. Love is not enough. Choose the person who will speak for you.
2. 2Not writing anything about life support. Your agent then guesses at the worst moment.
3. 3Letting the agent sign as a witness. In many states that makes the form invalid.
4. 4Keeping the only copy at home. The hospital needs it the day you arrive.
5. 5Using a form from another state. It usually works, but your own state form avoids questions.

An example

James is 58 and names his wife as agent, with his brother as backup. He writes that he does not want to be kept alive by machines if there is no reasonable chance of recovery.

After a heart attack he is unconscious for days. His wife shows the form, talks with the team each morning and makes the calls he asked her to make. His brother supports her instead of arguing.

Checklist before you sign

• Your state form, or one that meets your state rules.
• An agent and a backup who said yes.
• Your wishes about life support, nutrition and pain control.
• The right number of witnesses, who are not your agent.
• Copies ready for your agent, your doctor and your family.

People also ask

Can my medical agent refuse treatment for me?

Yes, if refusing follows your wishes or your best interest. Many forms ask you to say in writing whether your agent may refuse life-sustaining treatment, so the care team does not have to guess.

What if I recover after my agent made decisions?

The decisions go back to you as soon as you can make them. Treatment your agent chose can be changed by you from that moment on.

What is it called when someone makes medical decisions for you?

The person is your health care agent, proxy or surrogate. The document that names them is a medical power of attorney or health care proxy.

Does next of kin have power of attorney?

No. Next of kin may be asked to decide under state law when there is no document, but that is not a power of attorney.

Can a medical power of attorney be challenged?

Yes. A court can review it if someone shows the principal lacked capacity, was pressured, or the agent is not acting in their interest.

Does a medical power of attorney need to be filed?

No. It does not go to a court or a registry. Give copies to your agent and your doctors.

Forms to use now

• Medical power of attorney form
• HIPAA release form
• Durable power of attorney form for money and property

Sources

• Legal Information Institute, Cornell Law School, «power of attorney»
• ESIGN Act, 15 U.S.C. 7001, on govinfo.gov