A healthcare power of attorney—also called a healthcare proxy or medical power of attorney—authorizes someone to make medical decisions on your behalf if you cannot make them yourself. This document ensures someone you trust directs your care when you're incapacitated. Without a healthcare POA, medical decisions may fall to family members by default or require court intervention, potentially leading to outcomes you wouldn't want.
Healthcare POAs are distinct from financial POAs and living wills, though all three should be part of comprehensive advance planning.
When Healthcare POAs Take Effect
Healthcare powers of attorney typically activate when you cannot communicate your own medical decisions—due to unconsciousness, severe illness, cognitive impairment, or other conditions that prevent informed decision-making.
Doctors determine when you lack decision-making capacity. The threshold isn't permanent incapacity—even temporary inability to make decisions can trigger your healthcare agent's authority.
Unlike financial POAs, healthcare POAs are usually not "immediate"—they activate only when needed. You make your own healthcare decisions as long as you're capable.
What Healthcare Agents Can Decide
Healthcare agents can consent to or refuse medical treatments, choose doctors and hospitals, access medical records, authorize surgeries and procedures, make decisions about pain management, and decide about life-sustaining treatment.
Agents can make the same decisions you could make for yourself. This includes difficult end-of-life choices like withdrawing life support or entering hospice care.
Some decisions may require specific authorization: mental health treatment, abortion, organ donation, or experimental treatments. Review your state's requirements for these sensitive areas.
Choosing Your Healthcare Agent
Select someone who understands your values, can handle emotional medical situations, will advocate for your wishes even under pressure, and is geographically available when needed.
Your healthcare agent should know your feelings about quality versus quantity of life, your religious or philosophical views on medical intervention, and specific treatments you would or wouldn't want.
The best technical decision-maker isn't always the best agent. Someone who will honor your wishes matters more than medical expertise—they can consult doctors for medical advice.
Communicating Your Wishes
A healthcare POA names who decides, but you should also communicate what decisions you'd want. Have detailed conversations with your agent about your values and preferences.
Consider scenarios: What if you had a stroke and couldn't communicate? What if you were in a coma with uncertain recovery prospects? What if you had advanced dementia? The more your agent understands your thinking, the better they can represent you.
Document your wishes in a living will or advance directive that accompanies your healthcare POA. These documents work together to guide your care.
Relationship to Living Wills
A living will specifies your wishes about end-of-life care—whether you want life support, artificial nutrition, and similar interventions in terminal or vegetative conditions. It provides guidance but doesn't name a decision-maker.
A healthcare POA names your decision-maker but may not specify particular treatments. Having both documents provides complete coverage: the living will states your wishes; the healthcare POA names someone to interpret and implement them.
When living will instructions are clear, your agent follows them. When situations are ambiguous, your agent uses judgment based on your known values.
Making Your Healthcare POA Effective
Requirements vary by state. Most require the document to be signed, witnessed, and/or notarized. Some states have statutory forms that healthcare providers must accept if properly executed.
Provide copies to your agent, your doctors, and hospitals where you might receive care. Keep a copy accessible in your home. Consider registering with advance directive registries if your state offers them.
Review and update your healthcare POA periodically, especially after health changes, family changes, or if your agent's circumstances change.
Revoking or Changing Your Healthcare POA
You can revoke your healthcare POA at any time while competent. Simply telling your doctor you want a new decision-maker may be sufficient, though written revocation is cleaner.
Creating a new healthcare POA typically revokes prior ones. But notify anyone holding copies of the old document to prevent confusion.
Getting Legal Help
While healthcare POA forms are often simple, an estate planning attorney ensures your document meets state requirements, coordinates with other advance directives, and addresses your specific situation. They help you think through decisions and draft documents that clearly express your wishes. For something as important as who makes life-and-death decisions on your behalf, professional guidance provides peace of mind.