What is a condition that would require a health care proxy?

Is your spouse automatically your health care proxy?

This could be a problem.

It is one of the least discussed topics in the health care system, but one that is often problematic for families with an ill or dying loved one. The problem: your spouse may not have any legal right to make decisions about your medical care, or even to be present during your final hours. That is what the National Academy of Sciences reported in a study last year: A spouse's legal right to act as a proxy for the ill or dying patient can cause problems because the surrogate may not know how to handle that power responsibly, the report said.

We all want our spouses to take care of us when we get old, said Dr. James Fries, a professor of medicine at the University of Pittsburgh Medical Center and a member of the academy's committee on end-of-life care. But we don't always want our spouses to be making medical decisions.

Experts say many states, including Pennsylvania, don't require spouses to act as health care proxies. The lack of a requirement means that a spouse who has a say in the medical care of a dying relative can be bypassed if he or she doesn't know the appropriate procedures or if the spouse is not a medical expert.

It's a huge problem, said Dr. Paul Friesen, a palliative care specialist in Washington, D. We don't want people to die alone, but we want them to die peacefully.

It is a terrible conflict of interest for the spouse to be making decisions that can affect the quality of care of the patient, said Dr. Robert Krakow, a professor of medicine at New York University School of Medicine.

A few states require that a health care proxy be appointed by a court. In Pennsylvania, such an appointment can be made by a judge at the time of the patient's admission to a hospital. It also can be made at the time a patient's durable power of attorney is created.

Friesen said he believes the law should be changed so that a spouse who wants to be a proxy should be able to do so and that a patient's doctor should inform the spouse of that right.

Is a health care proxy the same as a DNR?

I've heard that the legal terms Health Care Power of Attorney and a Legal Physician's Determination are two ways to say "Let me die".

Is there a specific difference between the two terms, or should they be regarded as one and the same? The word "proxy" has various definitions in its usage. In this case it means authorization to make decisions on your behalf, generally under the direction of another person/body organization. Thus, for example, if you have a PPO health insurance policy, and the policy says "each enrollee can designate a proxy", then the insurance company has authorized their own nurse to decide for you.

If you were in a hospital emergency situation (say, you fell down an elevator shaft), the hospital would call a telephone number, and when a doctor answered would ask for the person who wanted to be called the medical person. If no one responded, the hospital would call out a code name "DNR" which stands for "do not resuscitate". So this is a formal way of saying "don't spend money getting me alive" or "don't even try to revive me".

There are two legal aspects of this term. One is that the person giving the instruction must have authority to do so. The other is that the person doing the authorizing must also be willing to perform the act if necessary. Thus, there can be "proxies" that are authorized to do everything, and yet fail to follow through with their instructions.

Now, in regard to physician orders. Physicians by law have a duty to follow those orders, and thus a physician is legally required to give a DNR if the patient does not want CPR. However, it is recognized that the doctor's first concern is the welfare of the patient. Therefore doctors may elect to save lives, even if the death is caused by a lack of action rather than a problem caused by the attempt to save life.

What is a condition that would require a health care proxy?

My son is 13 years old and recently found out that he has to fill out a form to qualify for medical care in case of an emergency.

This form is going to state that his parents are both in agreement to put him on life support if anything happens to him in an emergency. But he doesn't want any sort of life-saving measures. We want to respect his wishes but feel that it's our responsibility as his parents to make the decision. What can we do?

I am sorry for your situation. A health care proxy is only legal if there is a disagreement between the people that are named on the document. Your son could be over 18 years old and it would be considered a legal adult in all cases, including medical decisions. A court would likely rule that his parents had the final say, if no other family members were present to provide another opinion. A guardian ad litem may have another opinion, which can be sought from a judge, but that is very unlikely in your situation.

As far as the life support, you have to consider the options very carefully. If your son is in a persistent vegetative state with no signs of recovery, and no chance of getting better or having a life-threatening condition improve, then the answer to your question would be yes. Even if your son is awake and asking what is happening every day, these are very serious issues and if his condition does not change, and/or he has no chance of recovering, life support would be a major issue to most families and I understand how you are feeling. However, this is a big decision, so the best advice I can give you is to be honest and explain your reasoning as fully as possible with family members and anyone who is interested in what you are deciding.

What should I tell my parents if I am the one who wants life support? My mother and I have a strong relationship and we talk about everything, even serious topics. Now I'm 13, and if anything happened to me, she would want life support for me. She feels that my life is valuable and has the right to decide, even though she doesn't agree with me. How can I tell her that I agree, while still convincing her that her wishes don't matter?

A strong argument can be made for medical support of a minor, as a right of passage.

How do you explain health care proxy?

How to handle your dying relative's wishes?

What do you tell your dying relative's doctor and friends when they ask you for the same information?

Let me start with a few definitions. First, the term health care proxy refers to someone other than the patient who is legally responsible for making medical decisions on behalf of a patient, if the patient becomes incapacitated. (If the patient is not incapacitated, then it would be up to the patient to make decisions about his or her medical care.) Second, incapacitation means that a person is unable to make medical decisions for himself or herself. Third, a health care proxy is required when a patient is unable to make decisions for him or herself because of a permanent or temporary physical condition.

As a result of a stroke, my husband had to give up driving. We hired a company to provide transportation for him to and from his doctor's visits. We were told he needed a health care proxy, and I was asked to sign a document that would authorize that company to make medical decisions for him. I refused to sign, but after a year of him refusing to get the driver's license, we were no longer able to afford a driver and his wife, also my sister, agreed to take over his driving. She had never driven before, but was willing to learn.

The day she was driving us to the doctor's appointment, we heard the tires screech as she was pulling out of our driveway. A few hours later, we received a phone call that she had been in an accident. Luckily, she was able to walk away from the crash and no one was injured. I made sure that my husband was comfortable with everything she was doing. She was very competent and capable, but I kept reminding him that she was not qualified to make medical decisions for him.

After the accident, I was asked by our family doctor if I would agree to be my husband's health care proxy. I said yes. Our family doctor asked for me to sign a form authorizing him to make medical decisions for my husband if he became incapacitated. He explained that it would be up to me to make decisions about my husband's health care and life support, but I was to be the final decision maker if my husband became incapacitated.