A healthcare proxy is a legal document that names someone to make medical decisions on your behalf if you become unable to make them yourself. The person you choose is called your proxy, agent, or surrogate. It’s one type of advance directive, and it’s sometimes referred to as a durable power of attorney for health care or a medical power of attorney.
How a Healthcare Proxy Works
A healthcare proxy doesn’t go into effect the moment you sign it. It only activates when a physician formally determines that you lack the capacity to make your own medical decisions. That determination involves assessing whether you can understand the relevant medical information, appreciate your situation and its consequences, weigh the risks and benefits of treatment options, and communicate a choice based on your own values.
If a doctor determines you’ve lost that capacity, your named agent steps in and works directly with your medical team to make treatment decisions. The authority isn’t permanent: if you regain capacity, your proxy’s decision-making power ends and you resume control over your own care. The physician must document the incapacity finding in writing, including the specific reasons, the date, and their signature.
What Your Proxy Can Decide
Your proxy’s role is broad. They can consent to or refuse treatments, approve or decline surgeries, and make decisions about life-sustaining measures. They work closely with your healthcare team to ensure your preferences and values guide every choice. This is especially important in situations that unfold quickly or in ways no one anticipated, where a written document alone might not cover the specifics.
The proxy is expected to make decisions you would have made for yourself, not decisions based on what they personally want. That’s why having detailed conversations with your proxy beforehand matters so much. The more clearly they understand your goals, beliefs, and limits, the better they can advocate for you.
Healthcare Proxy vs. Living Will
These two documents are related but serve different purposes. A living will is a written record of your treatment preferences, religious or spiritual beliefs, and guidance for specific medical scenarios. It tells your doctors what you want. A healthcare proxy names a person who can respond to situations in real time, including ones your living will didn’t anticipate.
You can have both, and many experts recommend it. But if you’re only going to complete one, naming a proxy is generally the higher priority. A living will can’t ask follow-up questions, weigh new information, or adapt to an unexpected complication. A trusted person can. Having both gives your proxy a reference point for your wishes while still allowing them the flexibility to handle surprises.
Choosing the Right Person
Your proxy should be someone who knows you well enough to represent your values under pressure. That doesn’t always mean your closest family member. Consider someone who can stay calm in stressful situations, who is willing to speak up to medical professionals, and who can set aside their own feelings to honor what you would want. They also need to be reachable. A proxy who travels frequently or lives far away may not be practical if decisions need to happen quickly.
Talk to the person before naming them. Make sure they’re willing to take on the role, and walk them through your preferences in detail: how you feel about life support, pain management, quality of life, and any specific treatments you would or wouldn’t want. These conversations can feel uncomfortable, but they’re the foundation that makes the entire document useful.
How to Create One
You don’t need a lawyer. In most states, the form is straightforward and freely available through your state’s health department. In New York, for example, the only requirements are your signature and the signatures of two adult witnesses who are 18 or older. The person you name as your proxy cannot serve as one of those witnesses. Notarization is not required in many states, though requirements vary.
Once completed, give copies to your proxy, your primary care doctor, any specialists you see regularly, and close family members. Hospitals often ask whether you have advance directives when you’re admitted, so keeping a copy accessible saves time when it counts. Some people also store a copy with important papers at home or note their proxy’s contact information in their phone.
Changing or Revoking Your Proxy
You can update or cancel your healthcare proxy at any time, as long as you still have decision-making capacity. If you want to name a different person or change any details, destroy all copies of the old document and create a new one. Then make sure everyone who had the previous version, including your doctor, your former proxy, and your family, knows about the change and has access to the updated form. An outdated proxy floating around in a medical chart can create confusion at the worst possible moment.
Life changes like divorce, a falling out with your proxy, or a move to a new state are all good reasons to revisit the document. Since requirements differ by state, completing a new form that complies with your current state’s laws is worth the few minutes it takes.