A Health Care Proxy allows you to appoint someone you trust (an agent), like a family member or close friend, to make health care decisions for you if you lose the ability to make them yourself.

By appointing a health care agent, you can make sure that health care providers follow your wishes. Your agent can also decide how your wishes apply as your medical condition changes. Hospitals, doctors, and other health care providers must follow your agent’s decisions as if they were your own. You may give the person you select as your health care agent as little or as much authority as you want. You may allow your agent to make all health care decisions or only certain ones. You may also give your agents instructions that they must follow. 

The Health Care Proxy Form can also be used to document your wishes or instructions concerning organ and/or tissue donation.

About the Health Care Proxy Form

It is an essential legal document. Before signing, you should understand the following facts:

  • The form gives the person you choose as your agent the authority to make all health care decisions for you, including the decision to remove or provide life-sustaining treatment, unless you say otherwise in the form. “Health care” means any treatment, service, or procedure to diagnose or treat your physical or mental condition.
  • Unless your agent reasonably knows your wishes about artificial nutrition and hydration (nourishment and water provided by a feeding tube or intravenous line), they will not be allowed to refuse or consent to those measures for you.
  • Your agent will start making decisions for you when your doctor determines that you cannot make health care decisions for yourself.
  • You may write on the form examples of the types of treatments you would not desire and/or those treatments you want to make sure you receive. The instructions may be used to limit the decision-making power of the agent. Your agent must follow your instructions when making decisions for you.
  • You do not need a lawyer to fill out the form.
  • You may choose any adult (18 years of age or older), including a family member or close friend, to be your agent. If you select a doctor as your agent, they will have to choose between acting as your agent or your attending doctor because a doctor cannot do both simultaneously. Also, suppose you are a patient or resident of a hospital, nursing home, or mental hygiene facility. In that case, there are special restrictions about naming someone who works for that facility as your agent. Ask staff at the facility to explain those restrictions.
  • Before appointing someone as your health care agent, have a discussion first to ensure that they are willing to act as your agent. Tell them that they will be your health care agent. Discuss your health care wishes and the form with your agent. Be sure to give them a signed copy. Your agent cannot be sued for health care decisions made in good faith.
  • If you have named your spouse as your health care agent but later divorced or legally separated, your former spouse can no longer be your agent by law unless you state otherwise. If you would like your former spouse to remain your agent, you may note this on your current form and date it or complete a new form naming your former spouse.
  • Even though you have signed the form, you have the right to make health care decisions for yourself as long as you can do so, and treatment cannot be given to you or stopped if you object, nor will your agent have any power to object.
  • You may cancel the authority your agent gives by telling them or your health care provider orally or in writing.
  • Appointing a health care agent is voluntary. No one can require you to appoint one.
  • You may express your wishes or instructions regarding organ and/or tissue donation on the form.
  • Having a signed health care proxy form is the best way to ensure that health care is provided according to the patient’s wishes.

At MJHS, we value both personal and professional caregivers and recognize the critical work you do. That is why we have created these online caregiving resources to help you through this crucial time in your life.

If you need additional help and support caring for your loved one, please feel free to contact MJHS. We can recommend other care options available to you through one of our programs.

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