Should you say yes to becoming a medical power of attorney?

If a family member or friend asked you to serve as her or his medical power of attorney, what would your answer be? Many people say yes without a second thought, but you should take some time to understand what your responsibilities would be, why the person has chosen you, and what potential complications and conflicts you may encounter.

What is a medical power of attorney?

A medical power of attorney is a legal document that allows a person to make medical decisions on someone else’s behalf if that person cannot speak for him or herself due to an injury, illness, or condition like dementia. In it, you name someone you trust as your healthcare agent or proxy. Their job is to work with your healthcare providers to make sure you receive the types of care you want. For example, if you are not likely to recover and you do not want a feeding tube, mechanical ventilation, or CPR, your healthcare agent must tell your physicians and advocate on your behalf to ensure you receive care that is in line with your wishes. Your healthcare agent is legally required to follow your wishes as long as you’ve shared them with him or her.

In addition to a medical power of attorney, many people also create a healthcare directive or living will. This outlines in detail what types of care you do and do not want and in what situations your wishes apply. A copy of the living will should be shared with both treating physicians and the medical power of attorney.

Questions to consider before agreeing to be a medical power of attorney

Before you agree to become a medical power of attorney, ask why the person chose you.

• Is it because you would be available when medical decisions need to be made quickly? Do you have other responsibilities, like family or frequent travel for work that would make this difficult? Would you be able to spend a significant amount of time consulting with physicians about the person’s diagnosis, prognosis, and treatment options? Do you have physical or mental health issues that would make being a healthcare agent difficult or undesirable?
• Was the decision based on shared personal, religious, or moral values? Do you in fact share those values? How do you feel about making life and death decisions? For example, if the person wants to stop treatment so she or he can spend their remaining time without the difficult side effects caused by treatment, would you be able to respect that decision in the face of the deterioration of their health? Would that decision cause you more stress or grief than you feel you can handle?
• Were you chosen because they feel you will be assertive with healthcare providers to ensure their wishes are respected? It can be difficult to stand your ground faced with medical professionals who are recommending a different approach to care. Do you feel comfortable strongly advocating for the person’s wishes with medical professionals who may disagree with those wishes?

Issues you may face when making medical decisions

Serving as a medical power of attorney may mean facing some problems:

• Complicated family relationships: Family dynamics can play a big role in making it easier or more difficult for you to fulfill your duties. The person’s siblings, spouse, or partner may feel that the role should have been given to them, creating tension around the decisions you’ll be called on to make. Or they may not agree with the person’s wishes and dispute them with you and the treating physicians, heightening the stress associated with an already difficult situation.
• Contesting the choice: A person who is unhappy with who was chosen may contest the decision, believing it was made after the person was no longer competent or that the person was under duress. This can complicate the situation and require an investigation or a legal battle.
• Risk of legal action: If you know what the person’s healthcare wishes are and do not follow them, you may be at risk for being sued, which can result in significant legal costs as well as stress.

Taking the time to fully explore what being a medical power of attorney means can help you make a decision you’re comfortable with and prepare you to be effective in this important role.