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Massachusetts health care proxy

The Massachusetts health care proxy is the first legislation in Massachusetts providing protection for an individual's right to determine the course of his medical care in the event of future incapacity. By using the health care proxy, an individual may appoint another person to serve as his agent or "attorney-in-fact" to make health care decisions for him if he becomes incapable of making those decisions on his own.

Under the Massachusetts health care proxy law, M.G.L. c. 201D, any competent adult who is 18 years of age or over may appoint a health care agent.

The individual who appoints the agent is called the "principal." The principal can appoint anyone except an administrator, operator, or employee of a health care facility, such as a hospital or nursing home, where the principal is a patient or resident, unless that person is also related to the principal by blood, marriage, or adoption. back to top

When does the appointment of the Health Care Proxy become effective?

Your agent's authority to make health care decisions under the proxy law is activated upon a determination by the principal's physician that the principal has sustained loss of his or her capacity to make such health care decisions. The health care agent cannot act under the proxy until such determination has been made. back to top

The Agent's Duties:

The appointed agent or "attorney-in-fact" will make decisions about the principal's health care only when the principal is, for some reason, unable to make the decision.

For example, if the principal is temporarily unconscious, in a coma, or has some other condition or he is disabled where he cannot make or communicate health care decisions, then the agent can act.

These decisions will have the same authority as the principal's would, if he were able to make the decision, and will be honored over those of any other person, with very limited exceptions.

However, the agent cannot act until the principal's doctor determines in writing, that the principal lacks the ability to make health care decisions. If the principal gives his agent full authority to act, the agent can consent to or refuse any medical treatment, including treatment that could keep the principal alive.

An agent's decisions can only be made after talking with the principal's doctor or health care provider, and after fully considering all the options regarding diagnosis, prognosis, and treatment of an illness or condition.

During this research, the agent has the legal right to get any information, including confidential medical information, necessary to make informed decisions for the principal. Agent's health care decisions are also made according to the principal's religious or moral beliefs.

Even after the principal's doctor has determined that he lacks the ability to make health care decisions, if the principal objects to any decision made by his agent, the principal's decisions will be honored unless a court determines that the principal lacks the capacity to make health care decisions. back to top

Can you change your Massachusetts Health Care Proxy?

Periodic reviews are important to ensure that the documents you have signed are still in accord with your wishes. You can revoke your massachusetts health care proxy at any time by the following:

(1) the principal signs another health care proxy later on;
(2) the principal legally separates from or divorces his spouse and that spouse is named in the proxy as the principal's agent;
(3) the principal notifies his agent, doctor, or other health care provider, orally or in writing, that he wants to revoke the health care proxy; or
(4) the principal does anything else that clearly shows that he wants to revoke the proxy, for example, tearing up or destroying the proxy, crossing it out, telling other people, etc.

Hospitals are required by federal law to provide all patients with information on their rights under state law to make decisions with regard to their medical care, their right to make an "advance directive," and the hospital's policies regarding such rights.

The "advance directive" the hospital must advise a patient on is the health care proxy. If a patient does not have a completed health care proxy, his family may be asked to make decisions based upon what they believe the patient would want done. If the patient is without a family, a court will generally appoint a guardian to make those decisions on the patient's behalf. back to top

Should you execute both a Living Will and a Health Care Proxy?

Yes. The Living Will (link) is your own expression of your attitudes about your health care. This instrument is especially important if you do not have a person to appoint as your Health Care Proxy, or if the person you have appointed is not available. The Health Care Proxy is important because it names your selection of the person who is to make decisions on your behalf if you cannot do so. You will want to have your health care agent communicate the views expressed in the Living Will to your physician to be sure the physician understands your wishes. back to top

Will other documents be helpful to insure your wishes are carried out?

Yes. You should consider having a Durable Power of Attorney for property management so that your agent has power to provide funding for medical care and treatment. The agent appointed may, but need not be, the person who is the Health Care Agent in your Proxy. Your Health Care Proxy should not be combined with your Power of Attorney. back to top


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