Being a Health Care Agent

A health care agent represents another person when that person can’t speak for himself or herself. 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 called a Health Care Power of Attorney. The document also varies by state. The person must name you as his or her agent on the document.

What it means to be a health care agent

Your role as health care agent begins when the person can’t make medical decisions. This is known as loss of capacity for medical decision-making. This assessment can only be made by a licensed physician. You then make the decisions as needed. You do this by carrying out the person’s choices as noted in his or her advance care planning documents. These documents declare what kind of treatment the person chooses to have or not have. You may need to put aside your own values and opinions to carry out the person’s choices. This may include refusing or stopping life-sustaining treatments.

Carrying out your role

Your duties depend on what the person’s advance care planning documents say. Your duties may also depend on state law. In general:

• Before accepting a role as an agent, talk with the person. Be sure you know his or her choices. Ask questions. This will help you be his or her voice if and when it is needed.

• Be sure that the person’s health care team knows that you are his or her agent. Carry a copy of the document and proof of your identification.

• Make sure the health care team has a copy of the person’s advance care planning documents.

• Talk to the health care team and ask questions as often as you need. Stay informed about the person’s condition.

• Ask for any help you need to understand the medical situation. Ask about the person’s condition and prognosis. Ask about risks and benefits of tests and treatments. Find out all the facts and options.

• Speak on the person’s behalf with the health care 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 person. You may be able to review his or her medical chart. You can authorize the person’s transfer to another facility. You can also request a new health care provider for him or her. If you are not sure what your rights are at any time, ask a legal advisor.

When it’s time to make decisions

If the person’s choices 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 health care agent is not an easy role. But it is an important one. Remember that the person trusts you to carry out his or her choices.

If you need help

• Ask the health care team if you have trouble with a decision. They 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.