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What is a Health Care Directive and Medical Proxy?

What is a Health Care Directive and Medical Proxy?
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My friend Gina went through hell. Her mother got rushed to the hospital for abdominal pain and, days later, was being fed through a tube and administered as much morphine as was allowable. Gina was tormented about what to do: Authorize more treatment? Take her mother off the feeding tube? Try to get her mother to make her wishes known despite the pain? Without instruction, Gina found herself in an agonizing position that could have been avoided. Her mother could have appointed her Medical Proxy and left a Health Care Directive. Then all decisions would have been made before the crisis hit.

Since we are all no longer spring chickens ourselves, it is best if we know what these two documents mean and have them ready in case we ourselves suffer a health crisis.

Health Care Directive is a document that lays out what type of medical treatment you want if you can’t answer for yourself. The Health Care Directive puts in writing your wishes for medical care and treatment in detail—like what to do in case you lapse into a coma or have a terminal condition. You can opt for what is called “comfort care” only which means no one will try to keep you alive through artificial means, but will only take actions to make you comfortable. You can opt not to receive artificially administered food and water, for example.

The Health Care Directive document lets medical personnel know your treatment wishes, but you should also choose a Medical Proxy to make sure those wishes are carried out. Your Medical Proxy is the person legally authorized to make decisions for you about your care.

Choose this person carefully. Your child is not always the best choice. If they have always been closest to you, they may have trouble making the tough call if necessary. Pick someone (over the age of 18) who you can count on to carry out your wishes. Discuss this with them in-depth before you select them. Also pick out a backup person if your first proxy choice is unable or unwilling to be there to make the calls that need to be made. It is best to have someone local to you, as many decisions may have to be made at your bedside. You might not want to pick your husband or wife (they are most likely to predecease you.) Also, if you did choose your spouse and get divorced, be careful to change who is your Medical Proxy. Usually such a proxy will be revoked, but better safe than sorry—create a whole new document with your new proxy.

Both you and your chosen proxy must sign both of the documents in front of a notary and witnesses. There are some people who can’t serve as witnesses:

—A person who is related to you by blood, marriage or adoption

—A health care provider

—A person who works for a health care provider

—The operator of a community health facility or anyone who works at such a facility

—A person you have designated as your medical proxy or alternate proxy

—Anyone who will get any part of your estate when you die.

A copy of both documents should be given to the proxy, the backup proxy, the medical institution or nursing home and you should consider giving a copy to each of your kids or siblings so everyone is clear who is authorized to make decisions for you and what those decision are. Make sure your medical practitioner knows you have appointed a Medical Proxy and have a Health Care Directive signed.

You don’t even need a lawyer to create these documents. You can download them online for free at sites like or

You will be sparing your family from stress, give them relief from making painful decisions, and rest easier yourself knowing your wishes about your own care (and when to end it) will be carried out. Consider this part of cleaning up your side of the street before you go and realize these forms are a great last gift to your loved ones.




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