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Health Care Agents: Appointing One and Being One

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.

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Whom can I appoint to be my health care agent?

Your agent can be almost any adult whom you trust to make health care decisions for you. However, most states do not permit you to appoint your attending physician (unless the individual resigns as your physician) or employees of the institution in which you are a patient (unless they are related to you by blood or marriage).

The most important considerations are that the agent be someone:

  • you trust
  • who knows you well
  • who will honor your wishes.

Ideally, it also should be someone who is not afraid to ask questions of health care professionals in order to get the information needed to make decisions. Your agent may need to be assertive and not everyone is comfortable accepting this sort of responsibility. Therefore, it is very important to have an honest discussion with the person you plan to name as your health care agent before you make the appointment.

Some people assume that they should appoint their spouse or adult child to be the agent. This is perfectly acceptable; however, sometimes a spouse or child may not feel able to make difficult decisions. For example, a husband may say that even if he knew that his wife would not want to be maintained on life-support, he could not make a decision to stop treatment. Or an adult child may not be comfortable dealing with medical issues, raising questions with doctors, or, if necessary, challenging a doctor's authority.

If your close relatives have similar concerns, it can be a relief to them if you appoint a friend or other relative who might be more comfortable with the responsibility. Practical considerations such as location or availability may also influence your choice.

Often people assume that their closest relatives know what they would want, so they think it is unnecessary to discuss preferences with them. However, people sometimes find that when they actually talk with their loved ones about end-of-life issues, they have very different views. Talking openly about the possibilities and your preferences is essential to assuring that your agent knows what you want.

Everyone's situation is unique. Your decision about whom to appoint must be guided by your own circumstances and relationships.

WebMD Medical Reference from the National Hospice and Palliative Care Organization

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