Health care agents
Definition
When you are unable to speak for yourself due to an illness, your health care providers may be unclear as to what type of care you would like.
A health care agent is someone you choose to make health care decisions for you when you cannot.
Alternative Names
Durable power of attorney for health care; Health care proxy; End-of-life - health care agent; Life support treatment - health care agent; Respirator - health care agent; Ventilator - health care agent; Power of attorney - health care agent; POA - health care agent; DNR - health care agent; Advance directive - health care agent; Do-not-resuscitate - health care agent; Living will - health care agent
What is a Health Care Agent?
A health care agent is also called a health care proxy. This person will act only when you are not able to.
Why Have a Health Care Agent?
Your family members may be uncertain or disagree about the type of medical care you would like to or should receive. Decisions about your medical care may then be made by providers, hospital administrators, a court-appointed guardian, or judges.
A health care agent, chosen by you, can help your providers, family, and friends make decisions during a stressful time.
Your agent's duty is to see that your wishes are followed. If your wishes are not known, your agent should try to decide what you want.
Health care agents are not required, but they are the best way to be sure your wishes for health care treatment are followed.
What Can a Health Care Agent Do?
If you have an advance care directive, your health care agent can make sure your wishes are followed. Your agent's choices come before anyone else's wishes for you.
If you do not have an advance care directive, your health care agent will be the one to help your providers make important choices.
Your health care agent has no control over your money. Your agent also cannot be made to pay your bills. You would need to determine a power of attorney to manage your financial or personal affairs, if you are unable to.
What a health care agent can and cannot do differs by state. Check your state laws. In most states, health care agents can:
- Choose or refuse life-sustaining and other medical treatment on your behalf
- Agree to and then stop treatment if your health does not improve or if the treatment is causing problems
- Access and release your medical records
- Request an autopsy and donate your organs, unless you have stated otherwise in your advance directive
Before you choose a health care agent, you should find out whether your state allows a health care agent to do the following:
- Refuse or withdraw life-enhancing care
- Refuse or stop tube feeding or other life-sustaining care, even if you have not stated on your advance directive that you do not want these treatments
- Order sterilization or abortion
Choosing Your Health Care Agent
Choose a person who knows your treatment wishes and is willing to carry them out. Be sure to tell your agent what is important to you.
- You can name a family member, close friend, minister, priest, or rabbi.
- You should name only one person as your agent.
- Name one or two other people as backups. You need a backup person in case your first choice can't be reached when needed.
Talk to each person you are thinking of naming as your agent or alternate. Do this before you decide who should carry out your wishes. Your agent should be:
- An adult, 18 years or older
- Someone you trust and can talk to about the care you want and what is important to you
- Someone who supports your treatment choices
- Someone who is likely to be available in case you have a health care crisis
In many states, your agent cannot be:
- Your doctor or another provider
- An employee of your provider or of a hospital, nursing home or hospice program where you receive care, even if the person is a trusted family member
What You Need to Do
Think of your beliefs about life-sustaining treatment, which is the use of equipment to prolong your life when your body organs stop working well.
A health care proxy is a legal paper that you fill out. You can get a form online, at your provider's office, hospital, or senior citizen centers.
- In the form you will list the name of your health care agent, and any backups.
- Many states require witness signatures on the form.
A health care proxy is not an advance care directive. An advance care directive is a written statement that can include your health care wishes. Unlike an advance care directive, the health care proxy allows you to name a health care agent to carry out those wishes if you cannot.
You can change your mind about health care choices at any time. If you do change your mind or if your health changes, talk to your doctor. Be sure to tell your health care agent about any changes in your wishes.
References
Arnold RM, Kutner JS. Palliative care. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 3.
Burns JP, Truog RD. Ethical considerations in managing critically ill patients. In: Parrillo JE, Dellinger RP, eds. Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 68.
Iserson KV, Heine CE. Bioethics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap e6.
Pereira C. End-of-life issues. In: Olympia RP, Lubin JS, eds. Prehospital Emergency Medicine Secrets. Philadelphia, PA: Elsevier; 2022:chap 68.
Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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