If a family member or friend asked you to serve as his/her medical power of attorney, what would your answer be? Many people agree to assume this role without a second thought, but you should take some time to understand what your responsibilities as a medical power of attorney would be, why the person has chosen you to do this, and what potential complications and conflicts may arise. With that information, you’ll be able to make a more informed decision about taking on this important role for someone you care about.

What is a medical power of attorney?

A medical or health care 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 himself/herself due to an injury, illness, or condition like dementia. Within the document, you name someone you trust as your health care agent or proxy. Their job is to work with your health care providers to ensure you receive the types of care you want. For example, if your wishes are that if you are not likely to recover you do not want a feeding tube, mechanical ventilation, or CPR, your health care agent must express these wishes to your physicians and advocate on your behalf to ensure you receive care that is in line with your wishes. As a medical power of attorney, that person is legally required to follow your wishes if you have communicated them to him/her.

In addition to a medical power of attorney, many people also create a health care directive or living will. This document 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 think about before agreeing to serve as a medical power of attorney

Before you agree to become a medical power of attorney, ask why the person feels you’re the person he/she wants in this role.

Is it because you would be available when medical decisions need to be made quickly? Do you have other responsibilities, such as 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 serving as medical power of attorney 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 he/she 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 his/her 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 health care providers to ensure their wishes are respected? It can be difficult to stand your ground faced with medical professionals 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?

Potential problems a medical power of attorney may face

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

Complicated family relationships. Family dynamics can play a significant 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 a charged atmosphere 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 and tension 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 health care wishes are and do not follow them, you may be at risk of being sued, resulting in significant legal costs and stress.

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

Miles J. Varn is chief executive officer, PinnacleCare, and can be reached on LinkedIn.

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