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Why You Need a Health Care Proxy

By Heather Maloney
Beth Israel Deaconess Medical Center staff

While many people might not associate family gatherings with serious discussions, it can be an opportune time to talk to your loved ones about your health care preferences in the event that you are unable to speak for yourself. It's important that you make sure your decisions are known and that those closest to you are informed and prepared.

"Everyone in this country, even young people, should designate a health care proxy," says Stephen O'Neill, LICSW, JD, Social Work Manager for Psychiatry and Primary Care and Associate Director of the Ethics Support Service at Beth Israel Deaconess Medical Center in Boston. "You never know when something might happen, and if you become incapacitated, the proxy will ensure that your voice is heard."

Under Massachusetts law, your health care "proxy" (also called your health care "agent") is recognized as the person who can make health care decisions if your doctor determines that you are no longer able to make or to communicate health care decisions for yourself. This is different from a living will, which typically details a person's preferences about the use of life-sustaining medical treatments in the event of terminal illness.

Even if you have a living will, you need to designate a health care proxy as well. "The health care proxy is recognized as the predominant advance directive document. In the event that it becomes necessary, the clinical staff would use the proxy as evidence of a person's wishes," Mr. O'Neill says.

As long as the proxy form is executed properly (it needs to be witnessed, but no lawyer is required), the designated proxy will have full legal authority over your health care decisions if you become incapacitated, trumping even a spouse or adult children. But, says Mr. O'Neill, this can be a good thing.

"In some cases, the people closest to you may love you so much that they might not be able to do or say what you would wish," he says. "You have to think, would I want my spouse or children to have to make these decisions?"

Once you've chosen a proxy, it's important to have a frank discussion so that they understand your personal wishes, values, and beliefs very well.

"The proxy is supposed to articulate the patient's wishes, and what's most important to them," says Mr. O'Neill. "Is it preserving dignity? Independent living? The ability to participate in their environment? Don't focus on specific types of care you may or may not want; a well-informed proxy can help the clinical staff understand what the patient would want."

The final step is to actually fill out the form, which you can download from BIDMC's website. Once the form is signed and witnessed, you should give a copy to the proxy, the alternate, and ask your primary care physician to put a copy in your medical record.

"We want to do this for everybody, not just seniors," Mr. O'Neill says. "With elders, health is in the forefront of their mind, but they could set an example for the younger members of the family."

"You never know when something unexpected will happen, and you want someone to be your voice at the table," he says.

For more information on advance directives, visit

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

December 2014

Contact Information

Social Work Department
Beth Israel Deacones Medical Center
330 Brookline Avenue
Boston, MA 02215
Phone: 617-667-3421
Fax: 617-667-8701