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Health Care Agents: Appointing One and Being One

How does my agent make decisions?

Under most states' laws your agent is expected to make decisions based on specific knowledge of your wishes. If your agent does not know what you would want in a particular situation, he or she should try to infer your wishes based on their knowledge of you as a person and on your values related to quality of life in general. If your agent lacks this knowledge, decisions must be in your best interest. Generally, the more confident the agent is the decisions will accurately reflect your wishes, the easier it will be to make them.

In a few states, the law limits the agent's power to refuse some treatments in certain circumstances. State law, for example, may limit decisions to what the patient has specifically stated in the appointing document or in other documents such as a living will. You should carefully review your state documents.

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What if I know that members of my family disagree with my wishes?

To ensure that your wishes are followed, be certain that the person you appoint to be your agent understands your wishes and will abide by them. Your agent has the legal right to make decisions for you even if close family members disagree. However, should close family members express strong disagreement, your agent and your health care professional may find it extremely difficult to carry out the decisions you would want.

  • If you foresee that your agent may encounter serious resistance, the following steps can help: communicate with family members you anticipate may object to your decisions. Tell them in writing whom you have appointed to be your health care agent and explain why you have done so.

  • Let them know that you do not wish for them to be involved with decisions about your medical care and give a copy of these communications to your agent as well.

  • Give your primary care physician, if you have one, copies of written communications you have made.

  • Prepare a specific, written living will.

  • Make it clear in your documents that you want your agent to resolve any uncertainties that could arise when interpreting the living will. A way to say this is: "My agent should make any decisions about how to interpret or when to apply my living will."

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