Health Care Proxies

In your health care proxy, also sometimes known as a "health care power of attorney," you can designate the person (your "health care agent") to make decisions about your medical treatment if you are unable to do so.

The form that we recommend is one of very few pages. It allows you to designate your primary health care agent and an alternate if he or she is not available. You may impose limitations or directions upon care you will receive, but we recommend that you do not do so.

The health care proxy law was enacted in Massachusetts after the "living will" proved to be inadequate. The living will was not legally binding in Massachusetts. Most importantly, it was not practical to specify what health care actions were to be taken or rejected.

Living wills often used language such as "If I am terminally ill, I do not want heroic measures used to keep me alive." This did not address the major concern, which was not terminal illness (a condition which would result in death within six months or less,) but rather a persistent vegetative state.

On February 25, 1990 Terri Schiavo suffered cardiac arrest. Because of lack of oxygen to her brain, she lapsed into a persistent vegetative state. On March 31, 2005 Terri died. During the interim hundreds of thousands of dollars were spent on hospitalization and on legal challenges to her husband's wish to terminate her life support. If she had signed a health care proxy all of this would have been unnecessary.

It is impossible to write a living will that specifies all of the challenges that might arise in a final illness and the medical responses to those challenges. For this reason, the health care proxy was favored over the living will and for this reason we suggest that you do not attempt to limit the actions of your health care proxy.

You should make sure that your health care agent understands what you wish to happen if you should become ill. Your agent will have to make the decisions you would have made if you had been able. The time you spend in talking with your health care agent is important.