Medical Power of Attorney: A Basic Guide

What Is a Medical Power of Attorney?

A medical power of attorney, sometimes referred to as a medical POA, is a type of advance directive. Advance directives are legal documents that specify what actions should be taken in your medical care if you are no longer able to make decisions for yourself. A medical power of attorney allows you to name an agent who will have the authority to make difficult medical decisions on your behalf. The agent you designate can make these decisions only if a physician determines you can't make decisions for yourself, and if the decisions are within the scope of the authority granted in the document. All in all, filing a medical power of attorney lets you ensure that someone you trust can speak on your behalf if you become medically incapacitated.

A medical power of attorney is different from a financial power of attorney, an individual you select to make financial decisions on your behalf, or a general power of attorney, an individual you designate to act on any matter allowed by your state. Depending on the state where you reside, you may hear the term medical power of attorney referred to by different names. Some other common descriptions for medical power of attorney include the following:

• Advanced directive
• Advance health-care directive
• Durable power of attorney for health care
• Health power of attorney
• Medical power of attorney directive

Medical Power of Attorney vs. Living Will

Both medical power of attorney directives and living wills are advance directives. These essential tools come into play in circumstances when someone has a life-threatening illness and in cases of sudden accidents and medical conditions that prevent someone from speaking on one's behalf. Key differences between a medical power of attorney and living wills exist.

Medical Power of Attorney

A medical power of attorney directive allows you to name someone you trust to act as your agent if you cannot speak for yourself. You can have separate medical and financial power of attorney directives that appoint different agents to make decisions for you on health care and financial decisions, respectively.

Living Will

Unlike a medical power of attorney, a living will does not necessarily appoint an agent to make decisions for you. Instead, a living will allows you to put in writing your preferences about some life-sustaining treatments. For example, you can indicate whether you want interventions such as cardiac resuscitation, mechanical respiration, or tube feeding by using a living will.

Here is an article about writing a living will.

A medical power of attorney usually works together with a living will since the agent appointed via the medical POA can follow the wishes you outline in a living will. Overall, the medical power of attorney directive may offer more flexibility than a living will alone. One can't predict every medical condition that could arise in the future in a living will. In many states, the medical power of attorney and living will get combined into one form known as an advance directive form.

How Does a Medical Power of Attorney Work?

A medical power of attorney comes into play only in the case of serious medical conditions. Examples of medical conditions that could require your medical power of attorney to act on your behalf include:

• Falling into a coma due to a stroke or other brain injury
• Losing the power of communication due to dementia or disease
• Having a lapse of mental health that prevents you from being of sound mind

Only a doctor may decide when a medical power of attorney applies in situations such as the above. If a physician decides you can't speak for yourself, the medical power of attorney directive gives your agent control over taking the next steps so that you can get the best possible medical care according to your wishes.

Once you complete your medical power of attorney and any other advance directive document, such as a living will, you should make sure everyone involved in your care knows that the document exists and has a copy of it. You can give the following individuals copies of your document.

• Important family members
• Your physician
• Your hospital
• Your attorney

Choosing an Agent You Trust: Responsibilities and Questions to Ask

To set up a medical power of attorney, you need to assign someone you trust to act as your agent. You may hear agents referred to in a few ways, including the following:

• Attorney-in-fact
• Health-care proxy
• Health-care surrogate

A medical power of attorney authorizes an agent to make medical decisions such as the following:

• Drug treatments to pursue, if any
• Facilities and doctors to visit
• How aggressively to treat brain disease or brain damage
• Tests to run
• When and if you should undergo surgery
• Whether to disconnect life support
• Whether to pursue comfort and quality of life or do everything possible to extend an individual's life

Often, people choose a spouse, adult child, longtime partner, or best friend to act as an agent. Choose someone you trust, but only assign someone whom you know will carry out your wishes. For example, if you know that a spouse or child will find complying with a preference, such as not inserting a breathing or feeding tube, difficult, you may consider appointing someone else to act as your agent. In most states, your agent can't be your health-care provider.

Here is an article about choosing someone to make medical decisions on your behalf.

No matter whom you select, the person you choose must be a mentally competent adult. Your agent should also:

• Be able to put aside his or her feelings about a given medical option or procedure to ensure your wishes get carried out
• Be able to understand medical explanations that your physician describes and ask challenging questions when necessary
• Discuss your medical wishes with you, including relevant specific scenarios
• Read and understand your living will
• Understand your wishes about end-of-life care and medical options

You may also consider appointing an alternate agent if your primary power of attorney can't fulfill this responsibility.

Once you select a medical power of attorney, you should talk with that person on an ongoing basis about situations that could occur. Continue discussing how you want your agent to handle these situations. Although it is impossible to anticipate every potential circumstance, the more you discuss your wishes with your medical power of attorney in general, the better the individual can understand your desires overall.

Some possibilities you might wish to talk about include:

• Circumstances under which you might want more aggressive measures taken to sustain your life
• Other cases where you would not want aggressive actions taken to sustain your life
• How you feel about being fed through a tube
• How you feel about being hydrated through a tube
• Treatments you are afraid of receiving
• Whether you would want to get treatments such as tube feeding, mechanical ventilation, or antibiotics for a trial period, then have a treatment stopped after a set period if time passes without your condition improving
• Your fears about what could happen if you can't make decisions for yourself

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Medical Power of Attorney and State Laws

In addition to using different terms to refer to the medical power of attorney, different states also have various ways to enforce laws regarding the medical power of attorney. Research what your state requires to ensure you have a legally binding medical power of attorney directive.

Further, while many states honor other states' medical power of attorney forms, others do not. If you move after creating a medical power of attorney, you should verify that your document is valid in your new state and then update your document if needed.

Setting a medical power of attorney can save loved ones from making painful decisions in difficult situations. Work with an experienced lawyer to create the legal documents that make sure your wishes are precise.