A Power of Attorney (POA) is a legal document used to designate a trusted person to make decisions on your behalf. In the medical context, this term refers to a specific advance directive that only activates if you become unable to communicate or make your own healthcare decisions. This legal tool ensures your medical treatment aligns with your personal values and preferences, even during times of serious illness or injury. Importantly, the medical POA is entirely separate from the financial Power of Attorney, which only handles property and money matters.
Defining the Medical Power of Attorney
The Medical Power of Attorney, frequently called a Healthcare Proxy or a Durable Power of Attorney for Healthcare, is a formal document where an individual (the principal) appoints another person (the agent or attorney-in-fact) to oversee their medical treatment. The designation of this agent is limited strictly to healthcare matters, maintaining a distinct legal boundary from financial decision-making authority. The person you choose should be someone who understands your wishes and is prepared to advocate for them with medical providers.
The term “Durable” is a significant legal component, meaning the authority granted to the agent remains valid even after the principal becomes incapacitated. Without this durability, the document would automatically become invalid once the principal loses the ability to make decisions, defeating the entire purpose of the directive. The ultimate goal is to substitute the agent’s judgment for the principal’s when the principal is unable to speak for themselves.
Triggers for Agent Authority
Signing the Medical Power of Attorney does not immediately transfer authority to the agent; instead, the power only “springs” into effect upon a specific trigger. This trigger is the formal determination that the principal lacks the capacity to make or communicate healthcare decisions. Capacity, in this context, means the inability to understand the nature and consequences of a proposed treatment or refusal of treatment.
The treating physician usually makes this determination, sometimes requiring a second physician to concur, depending on state regulations. This finding of incapacity must be formally documented in the patient’s medical chart before the agent can legally assume their role. Once this official determination is made, the agent’s authority becomes active, allowing them to step in and manage the principal’s medical care.
Decisions Covered by the Document
Once the agent’s authority is activated by a determination of incapacity, the scope of their decision-making power becomes comprehensive. The agent is authorized to consent to or refuse any medical treatment, procedure, or medication on the principal’s behalf. This includes authorizing complex surgical procedures, selecting or changing medical facilities, and coordinating long-term care placements. The agent’s choices must always reflect the principal’s known preferences and values, not the agent’s personal beliefs.
The document must include language that satisfies the Health Insurance Portability and Accountability Act (HIPAA) requirements to grant the agent access to the principal’s medical records. For the agent to speak effectively with doctors and make informed decisions, this authorization is essential. This HIPAA authorization ensures the agent is treated as the principal’s “Personal Representative,” allowing them to access Protected Health Information (PHI) and review diagnostic test results and treatment plans. The agent’s power also extends to making end-of-life decisions, such as authorizing the withholding or withdrawal of life-sustaining treatments like feeding tubes or mechanical ventilation, based on the wishes outlined by the principal.
Establishing and Changing the Document
Creating a legally valid Medical Power of Attorney requires the principal to be a competent adult, meaning they must be of sound mind when signing the document. While requirements vary by state, the document typically requires the signature of the principal and either notarization or the signatures of two qualified witnesses. These witnesses are often required to be “disinterested,” meaning they cannot be the appointed agent or a beneficiary of the principal’s estate.
The document can be revoked or changed at any time, provided the principal is still mentally competent. The simplest way to make a change is to execute an entirely new Medical POA, which automatically voids the previous one. Alternatively, a principal can sign a formal written revocation document or communicate their intent to revoke orally to their healthcare provider. After any change or revocation, copies must be provided to the former agent, the attending physician, and any healthcare facilities that had the original document on file.