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A healthcare proxy is a person who represents a patient when the patient can’t speak for himself or herself. The name of this role varies by state. It may be called a Durable Medical Power of Attorney or Durable Power of Attorney for Healthcare. It may be called an agent, surrogate, or advocate. Or it may be called a representative or decision maker. It is an official duty that is identified by a legal document. The document also varies by state. The patient must name you as their proxy on the document.
Being a proxy means that you speak on behalf of the patient. Your role begins when the patient cannot make medical decisions. You then make the decisions as needed. You do this by carrying out the patient’s wishes as noted in their advance care planning documents. This is a series of legal documents. They also vary by state. They declare what kind of treatment the patient wishes to have or not have. Understand that you will speak for the patient only. You may need to put aside your own values and opinions to carry out the patient’s wishes. This may include refusing or stopping life-sustaining treatments.
Your duties depend on what the patient’s advance care planning documents says. They may also depend on state law. In general:
Before accepting a role as a proxy, talk with the patient. Be sure you know their wishes. Ask questions. This will help you be their voice if and when it is needed.
Be sure that the patient’s healthcare team knows that you are his or her proxy. Carry a copy of the document and proof of your identification.
Make sure the healthcare team has a copy of the patient’s advance care planning documents.
Talk to the healthcare team and ask questions as often as you need. Stay informed about the patient’s condition.
Ask for any help you need to understand the medical situation. Ask about the patient’s condition and prognosis. Ask about risks and benefits of tests and treatments. Find out all the facts and options.
Speak on the patient’s behalf with the healthcare team when needed.
Talk with family members and keep them informed.
Know your rights. You have the right to ask for information. You can ask for consultations and second opinions. You have the right to request or refuse treatment for the patient. You may be able to review the patient’s medical chart. You can authorize a transfer of the patient to another facility. You can also request a new healthcare provider for the patient. If you are not sure what your rights are at any time, ask a legal advisor.
If the patient’s wishes are clear in the advance care plan documents, ask for them to be carried out as noted. If they are not clear, talk with the healthcare team. Listen to the team’s recommendations. Talk with a spiritual advisor or counselor. It may be hard for you to make a decision at times. You may feel sad or upset about a decision. Being a healthcare proxy is not an easy role. But it is an important one. Remember that the patient trusts you to carry out his or her wishes.
Ask for help if you have trouble with a decision. The healthcare team will want to help you.
You may need help in resolving family conflicts. Ask the hospital social worker, ethics consultant, or a spiritual advisor for help.
If you are having trouble talking with the healthcare team, talk to the hospital ombudsman or ethics committee.