What Is A Healthcare Proxy?
A healthcare proxy or health care agent is an individual whom a patient chooses to make health care decisions for the patient. The patient may become too sick to make a medical decision. Medical decisions are those that involve tests, procedures, and other treatments that a healthcare proxy can do on the patient’s behalf. A healthcare proxy can also talk with the patient’s doctors and consult with the patient’s medical records.
Healthcare Proxy Criteria
There are different criteria for choosing a healthcare proxy. The first is that the healthcare proxy must be an adult or at least 18 years old. A healthcare proxy can be a family member, close friend, minister, priest, or rabbi. The patient must only name one person as a healthcare proxy or health care agent, and the other one or two people as alternate agents in case the first choice is not available when needed.
Secondly, the healthcare proxy must be the person that the patient trusts. The patient must divulge to the healthcare proxy sensitive information such as personal feelings toward health, illness, death, and drying. The patient should also share with their healthcare proxy about the patient’s religious beliefs and feelings about health care providers, caregivers, and health care institutions.
Next, the healthcare proxy must be the person that supports the patient’s treatment choices. Healthcare proxy must be aware of the patient’s medical treatment preferences, such as attitude toward palliative care, life-sustaining treatment, and other treatments that the patient needs in case of the patient’s unconsciousness.
The healthcare proxy must also be the person that will be available in case the patient has a medical care crisis or health care crisis. Health care crises may require quick medical treatment decisions, so the healthcare proxy must be good at making health decisions in changing circumstances while still applying the patient’s medical care preferences and wishes.
A patient is not allowed to name a person as the patient’s healthcare proxy if the person is the patient’s doctor or medical provider or an employee of the patient’s doctor at a hospital, nursing facility, or hospice facility where the patient receives care.
What Does A Healthcare Proxy Do?
A healthcare proxy does several things. The first thing is to choose or refuse life-sustaining and other medical treatment on the patient’s behalf. Life-sustaining treatments are used to extend the life of the patient by functioning as one of the patient’s organs. These equipment include breathing machines like ventilators, machines to help the patient kidneys like dialysis, feeding tubes into the patient’s stomach to provide food like nasogastric or gastronomy tube, tubes into the patient’s vein to give fluids or medicines like IV tube, and tubes or masks to supply oxygen.
The next thing that a health care proxy does is to agree to and stop treatment if the patient’s health does not improve or if the treatment is causing problems for the patient. The patient can still make healthcare decisions unless the patient’s medical doctor decides that the patient is not able to make healthcare decisions.
Another thing that a healthcare proxy does is to get access to and release the patient’s medical records. Access to the patient’s medical records is defined by the patient on the health care proxy document. The health care proxy document states the permissions that the patient gives to the health care proxy in terms of getting access to health records or other medical information.
Healthcare Proxy Legal Guidelines
There are several healthcare proxy legal guidelines as stated by the New York State Health Department (NYSDOH). The first guideline defines the health care proxy form as a document that gives power to the person whom the patient chooses to make all healthcare decisions. Healthcare decisions include treatments, services, or procedures to cure the patient’s physical or mental condition.
Next guideline states the power of the healthcare proxy to remove or provide life-sustaining treatment, unless the patient says otherwise in the health care proxy form. The healthcare proxy form also sets limitations of the healthcare proxy or health care agent about artificial nutrition and hydration. The artificial nutrition and hydration of the patient are not refutable or be given consent by the health care proxy.
The next guideline states that the healthcare proxy or health care surrogate can only start making decisions on the patient’s behalf when the patient’s healthcare provider determines that the patient is not able to make healthcare decisions. The patient can also specify the treatments that the patient desires and does not want to receive. These instructions must be followed by the healthcare proxy regardless of opinion or emotions.
The next guideline states that the patient does not need a lawyer to fill out the healthcare proxy form, and the patient may choose any adult who is 18 years old or older to be the health care proxy. The healthcare proxy can be a family member or close friend of the patient. The patient can choose the patient’s doctor to be the healthcare proxy as long as the patient’s doctor will choose between acting as the patient’s health care agent or as the patient’s attending doctor. There are restrictions in naming a health care proxy who works in a hospital, nursing home, or a mental hygiene facility where the patient is a resident of.
The next guideline states that the patient must discuss the details and issues with the potential healthcare proxy or health care agent before the appointment. The patient’s health care wishes and other details in the health care proxy form must be relayed to the potential health care agent. The health care agent must receive a signed copy of the healthcare proxy form. the health care proxy form must be signed in the presence of two adult witnesses. It also states that the health care proxy is immune from legal prosecution for healthcare decisions made in good faith.
The next guideline states that when the patient names the patient’s spouse as the patient’s health care proxy or health care agent, and they become divorced or separated, the former spouse is not allowed to by the patient’s health care proxy by law unless stated by the patient otherwise in the health care proxy form.
The next guideline states that the patient still has the power to make healthcare decisions even though the health care proxy form is signed. Healthcare decisions are made by the patient as long as the patient is able to do so and the patient can cancel the power and authority given to the patient’s health care proxy through verbal or written notice.
The guideline also states that appointing a health care proxy is voluntary, and no one requires the patient to appoint one. The patient can use the health care proxy form to express wishes or instructions about organ donation or tissue donation. The organ donation or tissue donation can be specified for transplantation, research, or educational purposes.
Health Care Proxy Powers And Limitations
The health care proxy powers and limitations are incorporated into the health care proxy document or the durable power of attorney document that gives the health care proxy or health care agent the authority or power to make healthcare decisions and financial decisions for the patient if the time comes that the patient is incapable of making those decisions. The healthcare proxy can agree that the patient should receive treatment, choose among different treatment options, and decide which treatment should not be provided, in accordance with the patient’s wishes and interest.
On the other hand, the healthcare proxy has limitations in terms of non-healthcare decisions. Non-healthcare decisions include financial decisions. Financial decisions are not part of the scope of the powers of a healthcare proxy but of a durable power of attorney. A durable power of attorney is a legal document that gives authority to an individual to make financial decisions on the patient’s behalf.
Health Care Proxy Capacity To Appoint
A study published in the American Journal of Geriatric Psychiatry evaluates the capacity of patients to appoint a healthcare proxy. The capacity to appoint a health care proxy decreases as the patient ages or suffers from dementia and other conditions affecting cognition. The study states that careful clinical assessment of the capacity to appoint a health care proxy may consider the patient’s understanding of two things. The first is what it means to give authority, and the other is how it is accomplished through the health care proxy document.
The study also states that the capacity to appoint a health care proxy is hindered by the lack of consensus or instruments to measure that capacity. Methods of assessing the capacity to appoint a health care proxy can be made clear by the continuous collaboration between clinicians, legal professionals, and researchers.
What Is The Difference Between A Health Care Proxy And A Living Will?
The difference between a health care proxy and a living will is the content. The content of a health care proxy states the appointment of the patient’s health care proxy or health care agent to make health care decisions on the patient’s behalf if the time comes that the patient is incapable of making such healthcare decisions. The content of the living will, on the other hand, states the patient’s health care wishes that are addressed to unnamed family members, friends, hospitals and other health care facilities.
The other difference between a healthcare proxy and a living will is the usage. The usage of a health care proxy is to give the health care proxy or health care agent the authority to make healthcare decisions for the patient in all medical situations that the patient is incapable of deciding in accordance with the patient’s values, wishes, and beliefs. The living will’s usage is to specify the patient’s wishes about life-prolonging procedures and other end-of-life care in order to correctly relay the patient’s instructions to the patient’s caregivers when the patient is unable to do so.
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