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Questions & Answers: Advance Directives and End of Life Decisions

What is a medical power of attorney?

A medical power of attorney is a document that lets you appoint someone you trust to make decisions about your medical care if you cannot make them yourself.

This type of advance directive can also be called a "healthcare proxy," "appointment of a healthcare agent," or "durable power of attorney for healthcare." The person you appoint may be called your healthcare agent, surrogate, attorney-in-fact, or healthcare proxy. The person you appoint through a medical power of attorney usually is authorized to deal with all medical situations, not only end-of-life decisions when you cannot speak for yourself. Thus, he or she can speak for you if you become temporarily incapacitated-after an accident, for example-as well as if you become incapacitated because of irreversible disease or injury.

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Generally, the law requires your agent to make the same medical decisions that you would have made, if possible. To help your agent do this, it is essential that you discuss your values about the quality of life that is important to you and the kinds of decisions you would make in various situations. For example, how aggressively would you want medical treatments supplied if you had Alzheimer's disease or if you were in a coma and unlikely to recover? Share your thoughts concerning someone you have known who was very ill and how you would want to be treated if you were in a similar situation. These discussions will help your agent to form a picture of your views regarding the use of medical treatments.

If this discussion does not take place, your agent will have to examine any general statements you might have made, your religious and moral beliefs, and what he or she knows about your values in general. When your wishes about a particular medical decision are not known your agent must act in your best interest, using his or her own judgment depending on your state's law.

Some states let you appoint an agent within the living will. This is different from a medical power of attorney, because an agent appointed in a living will can only make decisions about using medical treatments, and only if you are in one of the medical conditions specified in your state's law (such as "terminally ill," "permanently unconscious," or "imminently dying").

WebMD Medical Reference from the National Hospice and Palliative Care Organization

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