Why You Need a Health Care Proxy

Who will communicate your medical wishes if you’re unable?

a doctor and a medical proxy sit across a desk from another and review difficult choices.

 Sarinya Pinngam / EyeEm / Getty Images

“What if I get hit by a bus today?”

You might hear this question asked jokingly or semi-seriously, but regardless of the context, it’s worth considering. If something were to happen to you unexpectedly, and you were unable to communicate your wishes regarding medical care, who would be your voice? Who would make life or death decisions on your behalf? This is why you may need a health care proxy.

What’s a Health Care Proxy?

A health care proxy, also called a durable medical power of attorney, authorizes a person of your choosing to make critical health care decisions on your behalf if you’re incapacitated or unable to communicate. Your health care proxy might step in temporarily if it’s an injury that you later recover from, or permanently if you’re not expected to regain sufficient cognitive functioning to make decisions on your own behalf.

Some of the decisions they might be asked to make include:

  • Authorizing extraordinary measures to prolong your life
  • Authorizing dangerous treatments
  • Ceasing life support
  • Requesting second opinions
  • Conferring with family members
  • Other decisions based on the knowledge of your specific wishes
  • Decisions based on your religious or other beliefs

What If There Is No Health Care Proxy?

In most states, there is a procedure for appointing somebody to make decisions on behalf of the incapacitated person. This “surrogate” is chosen based on the laws of each state but often, the order starts with the person’s spouse or domestic partner, a child over 18, parent, sibling over 18, and finally a close friend or relative who doesn’t fit any of the above.

Although there’s a fallback plan in most states, it’s still best to have a health care proxy. Without clear direction from you, arguments among loved ones are possible. These arguments could lead to litigation being filed, which could cause critical treatment to be held up.

Who Should You Pick As Your Health Care Proxy?

Although you may automatically think of the person who loves you the most, that might not be the best choice. Look for these traits:

  • Makes hard decisions thoughtfully and quickly.
  • Works well with others. They have to work as a team with doctors, the family, financial professionals, attorneys, and others.
  • Looks past their emotions and makes decisions based on your wishes.
  • Stands their ground and carries out your wishes even when doctors, family members, and other parties are pressuring them to do otherwise.
  • Lives locally and can be involved in your care for weeks, months, or even years.

Looking at this partial list of criteria, the person you thought was the obvious choice may not be the best person. Find somebody who cares about you but can separate their feelings enough from the situation to make the decisions you would make if you could communicate.

How to Appoint a Health Care Proxy

Often, a health care proxy is part of the larger estate plan that an estate attorney would draw up, but you can also complete a single form based on the laws of your state.


Every state has its own policies and forms. Your local Agency on Aging can help you find the right ones.

Because this is a legal document, you will need to complete the form, have witnesses for the signing, and possibly need to have it notarized. Although something is better than nothing, having an attorney prepare the document may make it more capable of withstanding legal scrutiny.

What to Communicate to Your Health Care Proxy

First, they should have a copy of your health care proxy form and any other advanced directive documents you have completed. Next, make sure they know the names and contact information of all of your health care providers. Remember, they will have the right to all of your medical records, so they can share with other doctors and get second opinions.

The last part is to tell the person what is most important to you. You might start the conversation by saying, “What matters most to me is...” From there, fill in the gaps by discussing other situations that might come up. Do you want to be an organ donor? Do you want to be placed on a ventilator if your chances of survival are slim or none?

Key Takeaways

The golden rule of estate planning is to make plans before the plans are needed. You don’t want to leave decisions like these in the hands of the courts or people who may not have your best interest at heart. You’ve heard it before: The best defense is a good offense.

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The Balance uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. New York State Department of Health. "Deciding About Health Care." Page 3.

  2. California Office of the Attorney General. "Advanced Health Care Directive Form."

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