Understanding the Massachusetts Health Care Proxy: Why You Need One

-by Erin Bradbury

When you are healthy and able to speak for yourself, making medical decisions feels easy. But illness or injury can strike unexpectedly. If you become incapacitated, who will decide whether you receive life sustaining treatment or move to a nursing facility? In Massachusetts, the health care proxy is the legal tool that answers this question.

What is a health care proxy?

A health care proxy allows you – the principal – to appoint a trusted individual (your health care agent) to make medical decisions on your behalf if you become incapacitated. The agent’s authority springs into action only when an attending physician, in consultation with others, determines you lack capacity. Without a proxy, a court appointed guardian may need to step in, which is time consuming and stressful in an emergency. Many hospitals and nursing homes now require a current health care proxy on admission.

Why is a proxy essential?

• You choose your decision maker. Nominating your own proxy gives you control over who makes decisions for you if you cannot make or communicate health care decisions.
• Avoid guardianship proceedings. If no proxy exists, a court must appoint a guardian before any major decisions are made. Guardianship is public, costly and can delay care at critical moments.
• Broad authority with limits. Your agent can make a wide range of medical decisions, from consenting to antipsychotic medications to issuing Do Not Resuscitate (DNR) orders and authorizing admission to a skilled nursing facility. However, you remain free to limit the agent’s authority; and once you regain capacity, decision making power returns to you.
• Peace of mind. A proxy reassures loved ones that your wishes will be respected, reducing conflict during stressful times. You can also use the document to express preferences about organ donation or end of life care.

Who should be your health care agent?

Massachusetts requires your health care agent to be at least 18 years old. You can appoint one primary agent at a time and should name an alternate agent in case the first person is unavailable. Choose someone you trust to carry out your wishes and communicate effectively with medical providers and family members.

Tips for protecting your wishes

• Discuss your values. Talk with your chosen agent about your beliefs regarding life support, long term care and quality of life. Clear communication makes it easier for your agent to act confidently.
• Keep your proxy current. Each time you sign a new proxy, it revokes the previous one. Bring your current proxy with you when you are admitted to a hospital, and give copies to your primary care doctor and estate planning attorney.
• Consider additional documents. A proxy can include wishes about organ donation, but some people also complete a living will or medical order for life sustaining treatment (MOLST) to provide more specific guidance. These documents work together, not in place of each other, to ensure your voice is heard when you cannot speak.

Planning ahead

Planning ahead with a Massachusetts health care proxy gives you control over your medical future and spares loved ones from making agonizing decisions without guidance. If you have questions about creating or updating a proxy, consult the experienced elder law attorneys at our office. ...More Blogs

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