Healthcare proxy
In the field of medicine, a healthcare proxy (commonly referred to as HCP) is a document (legal instrument) with which a patient (primary individual) appoints an
Those over the age of 18 are allowed to have a healthcare proxy, and these documents are useful in situations that render a person unable to communicate their wishes such as being in a persistent vegetative state, having a form of dementia or an illness that takes away one's ability to effectively communicate, or being under anesthesia when a decision needs to be made.
History
The methods of healthcare planning and tools of advanced preparation have changed dramatically over the years. The concept of durable power of attorney arose in
Criteria
Some jurisdictions place limitations on the persons who can act as agents. (Some forbid the appointment of treating physicians as the healthcare proxy.)[7] In any event the agent should be someone close to and trusted by the primary individual.[7] According to the state of Massachusetts, no person who is an employee or administrator of a facility can be an agent unless it is for someone who is of familial relation to them. In any event, the agent is recommended to be someone close to and trusted by the primary individual. In the absence of a power of attorney, a legal guardian must be appointed.[8]
Legal guidelines
Healthcare proxies are permitted in forty-nine states as well as the District of Columbia.[7][9] Healthcare forms may differ in structure from state to state and pre-made forms are not compulsory as long as certain guidelines are met. The common guidelines include:[1]
- Name and address of the agent.
- Name and address of an alternate agent.
- Duration of the proxy – not indicating a duration means it is valid unless stated otherwise.
- Special instructions – these can broaden or limit the powers of the agent. If the patient doesn't want to be on feeding tubes no matter what, this can be stated here. If there are certain treatments that the patient does not want to receive like dialysis or blood transfusion, then they must be indicated. However, if the patient wants to give the agent more flexibility with some or no restriction, this must be written.
- Name, date and signature of the primary individual.
- Instructions on tissue or organ donation.
- Two adult witnesses must sign the document stating that they have witnessed this agreement and that both parties appear to be sane. The witnesses must be 18 years or older. The agent and primary individual do not qualify as witnesses.
- Presence of a lawyer - such a person may help in drafting a document tailored to the needs of the primary individual.
- Once signed, copies of the form must be given to healthcare providers, the agent, spouse, and close friends. A copy should also be carried by the primary individual (in wallet or purse).
Powers and limitations
The agent is empowered when a qualified
A person may identify end-of-life decisions in more than one legal document, such as in a living will in addition to a healthcare proxy, in which case it is necessary to examine all of the documents to determine if any limit or revoke the agent's authority as granted in the healthcare proxy.[10] An agent will not be legally or financially liable for decisions made on behalf of the primary individual as long as they follow the terms of the healthcare proxy.[11]
Capacity to appoint
There are limited legal foundations to determine the ability of someone to appoint a healthcare proxy. Although physicians are allowed to deliver life-saving treatment in emergent situations, in non-emergencies, it is determined if the patient has the ability to then appoint a healthcare proxy.[4] It is possible for a patient lacking the ability to make healthcare decisions, to still have the capacity to appoint an agent and have a proxy.
United Kingdom
In
See also
- Advance healthcare directive
- Doe ex. rel. Tarlow v. District of Columbia
- Do Not Resuscitate (DNR)
- Estate planning
- Living will
- Patient refusal of nutrition and hydration
- Power of attorney
- Ulysses pact
- Uniform Rights of the Terminally Ill Act
- Mental health law
References
- ^ a b "Health Care Proxy - New York State Department of Health" (PDF). New York State Department of Health. Archived from the original (PDF) on 2014-06-11.
- ^ "General Law - Part II, Title II, Chapter 201D, Section 4". malegislature.gov. Retrieved 2018-10-30.
- ^ "Healthcare Proxy - Who Will Speak for You?". www.health.ny.gov. Retrieved 2018-10-29.
- ^ PMID 23498379.
- ^ "Health Care Proxy/Living Will | Stony Brook Medicine". www.stonybrookmedicine.edu. Retrieved 2018-10-29.
- PMID 20579283.
- ^ a b c Rai A (September 1999). "The Physician as a Healthcare Proxy". The Hastings Center Report. Hastings Center. Retrieved 2007-10-14.
- S2CID 32809957.
- ^ Health Care Powers of Attorney: Interactive Map, LawServer. Retrieved on August 19, 2014.
- ISBN 978-1-118-03964-9.
- ^ "Myths and Facts About Health Care Advance Directives" (PDF). ABA Commission on Law and Aging. American Bar Association. Retrieved 8 May 2017.
Further reading
- Pope TM (February 12, 2010). "Surrogate Selection: An Increasingly Viable, But Limited, Solution to Intractable Futility Disputes (Widener Law School Legal Studies Research Paper No. 10-09)". St. Louis University Journal of Health Law and Policy. 3: 183. SSRN 1551979.
External links
- "Health Care Powers of Attorney" (PDF). American Bar Association. Archived from the original (PDF) on 2014-07-22. Retrieved 2014-08-19.
- "Massachusetts Law about Health Care Proxies and Living Wills". Massachusetts Court System. Archived from the original on 2014-10-01.