What Legal Authority Does Your Health Care Agent Have?
When it comes to planning for the future, one of the most important and often overlooked decisions involves choosing a health care agent, sometimes called a health care proxy or medical power of attorney. This is the individual you authorize to make medical decisions on your behalf if you're unable to do so.
At Edington Law Firm, Inc., in Modesto, California, I help clients with estate planning and trust administration. Here, I’ll explain the legal authority your health care agent has, how that authority is granted and limited, and what you should consider when choosing someone for this pivotal role.
What Is a Health Care Agent?
A health care agent is a person you designate to make medical decisions for you when you’re unable to make those decisions yourself. This designation is typically made through a legal document known as a health care power of attorney. This document is part of a broader category of advance directives that also includes living wills and HIPAA releases.
Importantly, your health care agent’s authority only becomes effective under certain conditions, typically when you’re incapacitated due to illness, injury, or mental decline. As long as you can make and communicate your own medical decisions, your health care agent can’t override them.
Legal Outline for Health Care Agents
The authority of a health care agent is rooted in state law. While the rules can vary slightly depending on your jurisdiction, most states follow similar guidelines for how health care decisions can be delegated. These laws are designed to protect both the principal’s autonomy and the integrity of the health care system. Most states follow similar guidelines that govern:
How a health care agent is appointed
When the agent’s authority becomes effective
What types of decisions the agent can make
Legal limits or exclusions to that authority
The role of health care providers and institutions in following an agent’s instructions
Each state typically provides a statutory form or outlines the minimum requirements for a valid health care power of attorney. These rules make sure that health care agents operate within a defined legal area and that their decisions carry legal weight. An estate planning attorney can help make sure your documents are properly executed and enforceable in your state.
When Does a Health Care Agent’s Authority Begin?
The authority of a health care agent usually begins when a physician certifies that the individual who created the document (the principal) is unable to make their own medical decisions. This makes sure that control over medical choices is only transferred when necessary. It provides a clear medical standard for when the agent’s authority takes effect. This might occur due to:
Unconsciousness following an accident or surgery
Dementia or other cognitive impairments
Mental health conditions
Temporary disorientation due to medication or illness
Once this determination is made, the health care agent may legally step in to make decisions on the principal’s behalf. This legal authority continues until the principal regains decision-making capacity or passes away. However, it’s essential to review the language of the document, as some health care powers of attorney allow the agent to begin acting immediately.
What Medical Decisions Can a Health Care Agent Make?
A health care agent typically has broad authority to make a wide range of health-related decisions. This authority is granted to make sure that someone can step in and advocate for the principal’s medical needs when they’re unable to do so themselves. These decisions can be critical to both immediate care and long-term quality of life.
Choosing or Changing Health Care Providers
The agent may select physicians, specialists, or medical facilities, including hospitals, nursing homes, or rehabilitation centers. They may also discharge providers or move the principal to a different care setting if appropriate. This allows the agent to seek out the best available care and respond to changes in the principal’s condition.
Approving or Refusing Medical Treatments
Health care agents can consent to or decline medical treatments, surgeries, diagnostic tests, and medications. Their choices are ideally guided by the principal’s expressed wishes or values. In the absence of specific instructions, the agent must use their best judgment to determine what the principal would want.
Accessing Medical Records
The agent has legal authority under HIPAA (Health Insurance Portability and Accountability Act) to access the principal’s private health records. This allows them to make informed decisions based on a full understanding of the medical situation. They can also authorize the release of information to other family members or caregivers when appropriate.
Managing End-of-Life Decisions
Perhaps the most emotionally charged authority a health care agent has is making end-of-life decisions. That’s why it's essential to clearly communicate your wishes in advance, so your agent feels confident in honoring them. This may include decisions about life-sustaining treatments such as:
Mechanical ventilation
Tube feeding
Dialysis
Resuscitation (CPR)
Palliative care and hospice
These decisions are often guided by a living will or other advanced directives. If those aren’t available, the agent must act based on the principal’s known values and wishes. The agent’s ability to balance medical realities with compassionate decision-making is crucial for these decisions.
Organ and Tissue Donation
Your health care agent may also be authorized to make decisions regarding organ donation, depending on the terms of the medical power of attorney or relevant state law. This authority can include consenting to donate specific organs, tissues, or the entire body for transplant or medical research.
Limitations on a Health Care Agent’s Authority
While a health care agent typically has broad powers, there are important legal and ethical boundaries to be aware of. These safeguards are designed to protect the principal’s rights and make sure that decisions made on their behalf remain within the scope of the law. Understanding these limitations can also help prevent future conflicts or legal challenges.
No Authority Over Financial Matters
A health care agent can only make decisions related to health care. They don’t have authority over your finances, property, or legal matters unless separately granted under a durable power of attorney for finances. Managing bank accounts, paying bills, or handling investments would require a separate document and a designated financial agent.
No Power to Override Explicit Directives
If you have a living will or other specific instructions about your care, your health care agent is legally obligated to follow those directives. They can’t override your documented preferences. For example, if your living will states that you don’t want artificial nutrition, your agent can’t authorize a feeding tube.
Prohibited Actions Under State Law
Some states restrict certain decisions even if the agent believes they align with the principal’s wishes. For example, certain states may prohibit agents from consenting to involuntary mental health treatment or sterilization. These restrictions vary widely, so it’s important to consult state-specific laws when drafting your health care documents.
Court Intervention
If there is a dispute about a health care agent’s actions, concerned family members or medical providers can ask a court to review or revoke the agent’s authority. Courts generally favor following the principal’s expressed wishes but will step in to prevent abuse or neglect. In extreme cases, the court may appoint a guardian to replace the agent.
How to Choose the Right Health Care Agent
Choosing a health care agent is a deeply personal decision. It’s about more than trust; it’s about confidence in someone’s ability to handle medical crises, make tough decisions, and advocate effectively with health care providers. When selecting your health care agent, consider choosing someone who:
Knows you well and understands your values
Can stay calm under pressure
Will communicate clearly with doctors and loved ones
Is willing to make difficult decisions if necessary
Will respect your wishes, even if others disagree
Your health care agent doesn’t have to be a family member, but they do need to be someone you believe will honor your preferences and protect your dignity. Make sure to discuss your values and treatment preferences with your agent well in advance. When you’re ready to move forward, contact Edington Law Firm, Inc, and I can help you establish your health care agent.
Communicating Your Wishes
To empower your health care agent to act in your best interest, it’s critical to provide clear guidance. Without direction, even the most well-meaning agent may struggle to make decisions that truly reflect your values. Taking the time to document and communicate your preferences now can significantly ease stress and uncertainty during a medical crisis.
Write an Advance Directive
An advance directive or living will outlines specific treatments you do or don’t want under various scenarios. This document serves as a blueprint for your agent and your medical team during critical moments. Clearly stating your wishes in writing minimizes confusion and helps reduce the emotional burden on loved ones.
Have the Conversation
Sit down with your health care agent and talk openly about your beliefs, values, and goals for care. These conversations can provide context that isn’t always captured in legal documents. You might discuss what quality of life means to you, your spiritual or religious views, or how aggressively you want treatment pursued in serious situations.
Share Copies
Make sure your health care agent has a copy of your health care power of attorney and any other relevant documents. It’s also helpful to provide copies to your physician and keep one accessible at home. Some people also choose to upload these documents to an electronic health record or carry a wallet card indicating their agent’s contact information.
Speak With an Estate Planning Attorney Today
The legal authority of your health care agent is extensive. When chosen thoughtfully and prepared with the right guidance, your agent can serve as a powerful advocate for your values. If you’re ready to appoint a health care agent, contact Edington Law Firm, Inc. My firm helps clients in Modesto, California, and the surrounding areas plan for the future with confidence. Call my office today to begin working together.