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Health Care Agents: Appointing One and Being One

Why should I appoint a health care agent?

When you appoint a health care agent, you are designating a person to be your voice and your advocate. Because making medical decisions is rarely simple, it is difficult to foresee all of the possibilities in advance. Having an agent permits the same kind of flexible decision making that would occur if you were able to talk with your doctors, ask questions, weigh the benefits and burdens of the treatments involved, and make decisions based on specific circumstances.

An agent usually is permitted to make decisions in a wide range of medical situations, not just those involving end of life, and can respond to unanticipated events. Decisions can be based not only on what you may have expressed, either verbally or in writing, but also on the knowledge of you as a person. Your agent can consent to treatment and refuse treatment. For example, an agent might consent to a trial of treatment and, if it does not have the expected benefit, authorize its withdrawal. Your agent can take into account other concerns you may have, such as the quality of life that matters to you, your values or religious views, and other personal concerns that might affect your decisions.

In addition, an agent can advocate on your behalf. If a physician is unwilling to honor your wishes, the agent can seek another physician, go to the administrator or ethics committee on your behalf, or take other actions to see that your wishes are respected. Your agent can have access to your medical records and can seek a second opinion for you. Your agent also can see that you receive appropriate pain management and palliative care.

How does appointing a health care agent differ from creating a living will?

A living will is a document that provides specific instructions about end-of-life care. It may be called a medical directive, declaration, or something else, but its purpose is to give specific directions or guidelines for the care you want to receive. In contrast, a medical power of attorney is a document in which you designate a person to make medical decisions that may or may not be limited to end-of-life care.

Generally, the appointment of a health care agent permits more flexible decision making. Living wills, when used without a health care agent, are more limited as a tool for decision making because they cannot address unanticipated medical situations and might be difficult to interpret in a particular circumstance.

 

If I appoint an agent, should I prepare a living will?

In most states it is not necessary to prepare a living will or other directive if you have appointed a health care agent; however, living wills can still be useful. If the agent must make a difficult decision, the instructions you have given in your living will can reassure your agent that your wishes are being followed.

Furthermore, if the person you appointed to be your agent becomes unavailable to speak for you, your living will can provide useful guidanceto your caregivers. A thoughtfully prepared living will can be a valuable complement to the appointment of an agent.

WebMD Medical Reference from the National Hospice and Palliative Care Organization

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