Think Twice Before Signing That Health Care Proxy

Going to the hospital for a procedure can be stressful and, at times, confusing. A hospital will usually ask you if you have a Health Care Proxy (HCP) in place. If you do not have an HCP, or are unsure, they will ask you to sign a simple Massachusetts HCP form. As you are probably more worried about your medical procedure at this point, you don’t give it much thought – but should you sign this standard-looking document?

The short answer is “yes” if you haven’t signed one before. Having a valid HCP in place is critical for every adult. This legal document allows you to name someone you know and trust to make health care decisions for you if you become unable to make or communicate those decisions. Without a valid HCP, most health care facilities will insist that the court appoint a guardian for you. This is both costly and time consuming, and the court-appointed guardian may not be the person you would want making your health care decisions or even someone you know.

However, signing a new HCP with every health care provider or every time you go to the hospital can have terrible consequences. Each time you sign a new HCP, you revoke any previous ones you may have had in place. This may have serious unintended consequences, such as:
• Changing who you have chosen as your proxy – maybe in haste to sign a new document, or in your compromised condition (due to illness) you name a decision maker who you would not otherwise want long term in this important position.
• The hospital HCP typically does not contain the explicit authority that a more comprehensive, attorney-created document may have. This would include authority to administer anti-psychotic meds or authority to admit to a skilled nursing facility (nursing home). Without this authority in the HCP document, the skilled nursing facility and other providers will require your family to obtain a court-appointed guardian.

Having multiple documents, signed at different times, with different sources (such as one with your doctor’s office, one with the hospital, and one with your cardiac specialist) can cause confusion and major problems. This could include:
• Were you competent when you signed?
• If you changed your decision makers, does the most recently dated document accurately reflect your wishes?
• Having different people listed with different health care professionals.
• And finally, you could be unintentionally setting up your loved ones for a court battle as to who really is the decision maker you wanted.

A better plan is to create a HCP when you’re not under the stress of having a medical procedure. You should carefully consider the person you want to step into your shoes to make medical decisions and the types of authority you want to give that person. Once you sign this document after careful review and thought, make sure you give a copy of this document to all your health care providers and to the person you name as your proxy.