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Health Care Agents - Appointing One and Being One

Being a Health Care Agent

Why would I want to be a health care agent?

Accepting the appointment to be a health care agent is a way of affirming the importance of your relationship to the person appointing you. However, accepting an appointment requires thoughtful consideration about whether you can fulfill the role appropriately. Acting as a health care agent brings significant responsibilities and should be viewed as an honor to be given such trust.

There also are practical reasons for accepting formal appointment as an agent. If you are the closest relative to the patient, you can expect to be the person that health care professionals will look to for consent or decisions if the patient cannot make them. However, some state laws limit this informal decision-making process, particularly in cases of decisions to forgo or withdraw treatment. Without a formal appointment you may be able to consent to treatment but not refuse it or have it stopped, even if you know it is unwanted. To stand by helplessly watching someone you love be treated in a way you know that person would not have wanted can be a very painful experience.

If there is a conflict among family members and no agent has been designated, medical providers will normally continue all treatment until the conflict is resolved. Even if you are the person who knows the patient best and the one in whom the patient has confided, you may be unable to speak for the patient unless you are the legally designated agent. You may be excluded from decisions, particularly if you are not a close relative. It is not uncommon today for a friend to be closer to a person than family members who may live far away. If you are a formally-appointed health care agent, your authority has priority over all others, including family members.

What are my responsibilities as a health care agent?

As the health care agent you have the power to make medical decisions if the patient loses the capacity to make them. Unless your authority to act is limited by the patient or the state law, you normally can make all medical decisions for the patient, not only end-of-life decisions. In most states, as the health care agent you can also speak for the patient even if he or she becomes temporarily incapacitated as might occur after an accident. Generally, you may speak for the patient only as long as the patient is unable to make decisions.

You need to read the state forms and the instructions carefully to find out if there are any limitations upon your authority to make health care decisions. For example, in a few states your authority to make end-of-life decisions is limited to circumstances addressed in the document. Some limit the agent's ability to make decisions related to psychiatric hospitalization or shock treatment. A few states require that the agent have some specific knowledge about the patient's wishes regarding artificial nutrition and hydration or other specific treatments.

WebMD Medical Reference from the National Hospice and Palliative Care Organization

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