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A Healthcare Power of Attorney , referred to in some states as a Healthcare Power of Attorney for Decision Making (HPoA) is one of the legal documents known as Advance Directives.

A HPoA appoints another adult (known as your "agent" or "proxy") to make medical decisions for you if you become unable to communicate or to decide for yourself, including making decisions about whether to remove or provide life-sustaining treatment.  Generally, a HPoA also includes a person to act as proxy in the event your first choice is not available or unable to act as proxy or refuses to act. This person is known as an Alternate.

The Healthcare Power Of Attorney Document

  • Free HPoA forms for each state are readily available. (For information, click here offsite link.)
  • When executing a Healthcare Power of Attrorney, It is advisable to:
    • Name only one person as proxy.
    • Name an alternate in case the first person can't be reached, decides not to carry out your wishes, or is unable to serve as proxy.
    • Tailor standard forms to your individual needs. For instance:
      • If you also have a Living Will., you can state that if there is a conflict between what is stated in the Living Will and what the Proxy wants, the (living will)(proxy) controls. 
      • In most states you can set an expiration date or other conditions for the HPoA to expire. 
  • A HPoA must be executed in the manner required by the state in which you live. If you move to, or are treated in, another state, an additional document which conforms to the law of that state should be executed using the same proxy so there is no question about whether the document is valid when needed (at which point it is too late to execute another document).
  • A HPoA can be revoked at any time simply by ripping up the document.

The Proxy

  • It is advisable to appoint only one person as proxy and one as alternate. If there are two or more people in either position and they do not agree, the disagreement could cause unnecessary delay and expense. (Some states prohibit more than one person.)
  • You can give your proxy as little or as much authority as you want. You can even limit the proxy's authority to make decisions only about specific health care treatments. 
  • Your proxy:
    • Must act according to your known wishes. If your wishes are not known your proxy must act in your best interests.
    • Is not liable for treatment decisions made in good faith.
    • Is not required to pay for your health care costs.
  • When consnidering who to choose as proxy and alternate, look for someone who will not only carry out your wishes, but will also enforce them if there is any resistance from a doctor and/or health care facility. There are six steps to choosing the best person to act as Proxy and the person to act as alternate Proxy. 

Healthcare Power Of Attorney Tips

  • Discuss your wishes with your Proxy and alternate. You do not have to be specific. General statements about your wishes give guidance to fill in the blanks if the time comes.  Also let the person know that we have information about  how to enforce your wishes if the hospital or other health care provider doesn't agree. 
  • Avoid enforcement problems by checking with your doctor to be sure he or she will comply with your wishes. Do the same with any hospital or other health care facility you consider using.
  • Execute enough duplicate originals so you can give one to each of your doctors and to any medical faclity you enter. Store at least one original copy in a safe, easily accessible place (and be sure to tell the people involved, where the document is located).
  • Be sure that the people close to you know to contact the proxy in case something happens - and how to make contact.
  • At least once a year, and after a significant physical event, it is advisable to revisit your Healthcare Power of Attorney document and choice of Proxy/Alternate Proxy. Beliefs and your perspective of people can change over time.  When you review the document, add the date and your initials so people know the document continues to reflect your wishes.
  • Carry a copy of your proxy form in your wallet. It will help emergency medical personnel figure out who to contact if necessary. You can download a wallet size version of a "Health Care Proxy" from the state of New York by clicking here offsite link
  • In order to retain as much control as possible, it is advisable to also have a Living Will which can serve as a written guide about your thoughts. Also consider whether to execute a Do Not Rescuscitate Directive (a "DNR") which tells emergency personnel not to revive you if your heart or lungs stop working.

For additional information, see:

For additional information, such as the following which is common to all advance directives, click here:

  • How Do I Get A Free State Specific Copy Of A Healthcare Power Of Attorney And Other Advance Directives?
  • How Is Incapacity Determined?
  • What If I Move Or Receive Treatment In Another State?
  • How Often Should I Revisit My Living Will And/Or Healthcare Power Of Attorney?
  • How To Make Sure That A Hospital Or Other Healthcare Provider Will Follow Your Wishes
  • How To Change Or Terminate A Health Care Power Of Attorney (Or Other Advance Directive)

NOTE: A Healthcare Power Of Attorney only applies to physical situations. Also consider executing an Advance Directive For Mental Health. To learn more, click here.

Why Should I Have A Healthcare Power Of Attorney?

If you become too sick to make health care decisions, someone must decide for you. If you don't choose who that person is, the state will choose the person on either a temporary or permanent basis under laws generally referred to as Surrogate Consent Laws. Even if the court chooses the same person you would have chosen, the person will be left to his or her own devices unless you've had a conversation about your desires. Without knowing your wishes, it is not likely that someone close to you will authorize termination of unwanted treatment on a timely basis subjecting you to unnecessary treatment and your estate to unnecessary expense.

It is easy to think that if you have a Living Will, you don't need a Healthcare Power of Attorney. The problem with this thinking is that a Living Will describes specific circumstances and what you do or do not want to happen. This can work well in black and white situations. However, medical care is seldom black and white cut and dry. A proxy has the discretion to consider all the then current facts, think about your expressed desires, and make a decision that he or she think you would have wanted made.

Also, without a Healthcare Power Of Attorney there can be unnecssary conflict or confusion among your loved ones as well as with the medical team.


Why Do I Need A Healthcare Power of Attorney If I Have A Living Will?

Since this subject applies to more than one Advance Directive, see: Why Do I Need A Healthcare Power of Attorney If I Have A Living Will?

What To Do With The Original And Copies Of A Healthcare Power Of Attorney

Give the original of your Healthcare Power Of Attorney to the person who will serve as Proxy. If you appoint an alternate person as well, give a duplicate original to him or her. (A duplicate original is executed the same way as the original - with an original signature rather than a copy).

Give a copy to your attorney. File another copy in a safe place that you can access as needed. (There is no reason to keep a copy in your safe deposit box. )

To Learn More

How Is Incapacity Determined?

In general, a doctor will determine whether you are can make and communicate rational choices about your medical care. 

In a Health Care Power Of Attorney, you can name a doctor or doctors you wish to make the determination. Alternatively, you can specify a number of doctors who need to agree to the certification before it becomes effective. For example, two doctors.

As a general rule, hospitals and other health care facilities will not honor an advance directive unless there is confirmation about your status from at least one doctor.

NOTE: If you name a specific doctor or doctors, before executing a Health Care Power Of Attorney, speak with that doctor to assure he or she is willing to assume the role. Keep in mind (a) that the doctor may not be available when needed and (b) the doctor may move, stop practicing or die. At the least, make a continuing alert (such as every 6 months) to check to see that the doctor is still available.