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Healthcare Proxies

A healthcare proxy* becomes relevant only when individuals are no longer able to make healthcare decisions for themselves. Physicians and hospital officials turn to the agent - usually a family member or close friend - named in the healthcare proxy only when a satisfactory response from the ill or impaired individual is impossible. Nevertheless, a healthcare proxy should be prepared well in advance of any illness, because the need for it can arise in an instant after a stroke or some type of accident.

By law, the agent named in a healthcare proxy is authorized to make a full range of medical decisions for the person affected – with two exceptions. The agent may not refuse to allow the person to be given artificial nutrition (typically a tube that is surgically implanted in the stomach and provides nourishment) or artificial hydration (usually an intravenous line to provide fluids).

If the person signing the healthcare proxy wants the agent to be have authority to address these two issues, additional language must be added in the space that the proxy form provides for "optional instructions." To give the agent maximum flexibility to decide for or against artificial nutrition and hydration, it is usually prudent to include a direction to this effect:

I have discussed artificial nutrition and hydration with my agent. He/she knows my wishes and is fully authorized to make all decisions for me in these matters.

Another issue that arises in the treatment of the seriously ill involves the privacy of someone's medical records. Frequently parents may be able to make decisions, but they want their children to have access to details of their medical records so the children can give them reasoned guidance. For this reasons, it is also generally prudent to include the following line in the "optional instructions" section of the healthcare proxy:

I direct that my agent be given access to my medical records, even if I am still able to make medical decisions for myself.

Unlike the rules for powers of attorney, the healthcare proxy law provides for only one agent to have authority at any one time. The law allows for a "backup agent," but that person may act only if the primary agent is unable or unwilling to do so. There is no prohibition against family members discussing important decisions and attempting to reach a consensus, but in the end only one person may have the authority to convey a final decision to a doctor or a hospital on a treatment plan.

For more on healthcare proxies and proxy forms, visit the New York State Department of Health online.

*The applicable status are found in §§ 2980 through 2994 of the Public Health Law. A model text is provided in § 2981(5)(d).