Healthcare Power of Attorney (HCPA)

What Is a Healthcare Power of Attorney?

A healthcare power of attorney (HCPA) is a legal document that allows an individual to empower another person to make decisions about their medical care. A healthcare power of attorney refers to both a legal document and a specific person with legal authority.

Understanding Healthcare Power of Attorney

The healthcare power of attorney helps people who cannot communicate to exert their wishes regarding their medical care and treatment. The persons listed on the HCPA document become the sick or injured person's agent or healthcare proxy. Usually, the form asks for alternates in case the first-named HCPA is not available to serve in this capacity. Each state might differ in this and other such details, however, so you'll need to consult your own state's rules and forms when arranging for an HCPA.

Healthcare proxies can communicate with the patient's doctors to prevent unwanted treatments and avoid making the wrong decisions. They also have the power to make medical decisions for the person who is incapacitated. Writing an HCPA is straightforward — you fill out a form and have it notarized. Moreover, you can change or revoke who you want to be your healthcare proxy at any time by simply destroying the old HCPA and completing a new one.

Anyone may serve as a healthcare power of attorney, or an attorney-in-fact. Your HCPA can have any type of relationship with you — this person might be your friend, partner, lover, relative, or colleague for example. You are free to choose anybody, so long as you trust them and feel that they are competent.

The healthcare power of attorney serves a vital function during both periodic illnesses and at the end of life.

Why Would Someone Want, or Need, an HCPA?

Making Life Better

Imagine that you are the sick person cited above. Not only are you sick, but you're also debilitated — you can't speak or move, and possibly can't even think. What might this look like? You might be in such terrible pain that you literally cannot speak. Maybe you are unconscious as the result of an accident. Perhaps you are a terminally ill patient who has entered into a coma. If you've ever found yourself in these types of situations, and come out alive, you likely would have been grateful that your HCPA was in place to communicate with your doctors and others for the sake of your wellbeing.

Making Death Better

Of course, if you are dying or comatose, you might not actually witness your healthcare proxy speaking with your doctors. But some people might take comfort now in the thought that when they are dying, their healthcare proxy will be there to ensure that their wishes are fulfilled properly. The HCPA serves an important function both during periodic illnesses and at the end of life.

A Very Personal Decision

On the other hand, some people might not want an HCPA. Perhaps they are uncomfortable with the concept of someone making decisions for them. Maybe they don't want to envision a situation where they are physically debilitated or comatose, or it could be that some people just don't want to think about their deaths at all while they are alive.

As with other major life decisions, whether or not to engage an HCPA is a personal choice. A healthcare power of attorney may not be for everybody.

How It Works

When the patient, owner of the HCPA, becomes too ill to communicate their wishes about their medical care to others, the HCPA becomes activated — meaning that the person you named in the document has the power to make life and death decisions about and for you. Now, "HCPA" refers to both the HCPA document and the person you named in it.

An HCPA could say to my doctors, for example, "If Carla cannot breathe on her own, then she does not want any life-saving measures to be taken for her." Aside from specific directives like this one, you can include in your HCPA filing more general insights such as your religious beliefs, morals, and basic ethical values.

Choosing a Healthcare Proxy

Critical to Self-Care

Naming a healthcare power of attorney is an important step toward caring for yourself. Having an HCPA lets everyone, including your doctors, know the exact nature of your wishes were you to face big medical decisions but be unable to communicate. Knowing your wishes can help lift the burden — of trying to guess what they are — from others. The more they know about your treatment preferences, the smoother your care can be.

An Intimate Calling

It is an understatement to say that you must trust your HCPA. Of course, you should trust them. But because you'll be sharing intimate self-knowledge with this person, you also need to have a special rapport with them; relaxed enough to be your true self — no holds barred. This is true no matter what other roles your HCPA serves vis-à-vis you. So, before choosing an HCPA, consider carefully. However, relationships change, as do our feelings toward others. So what if you feel that you've made a mistake?

You Can Change Your Mind

You are truly free to choose anyone you want as your healthcare proxy; this includes the freedom to reverse your decision at any time. If you want to assign a new HCPA, just eradicate the original document and create a new one designating the new HCPA.

Not everyone has an HCPA, but if more people understood this term, perhaps they would see the benefit of assigning one.

How to Set Up an HCPA

To appoint someone as your healthcare power of attorney, you may fill out a form that names the individual along with any stipulations that you wish them to have regarding your medical care. The form will also list any special requests you may have, such as asking for a do-not-resuscitate (DNR) order and avoiding interventions that will extend your life.

Some states — namely Indiana, New Hampshire, Ohio, Texas, and Wisconsin — do not permit a universal power-of-attorney form and require that you use their state-specific form instead to designate your power of attorney.

Some states also require witnesses to be present if the individual is in a nursing home or care facility. A basic healthcare power of attorney form will require you to list your name, birthday, date, and the identifying information of the individual that you are naming. You can also name two back-up agents in the event that your first preference is not available or unwilling to take on the role. If you live in Missouri, North Carolina, South Carolina, or West Virginia, the form must be notarized. The healthcare power of attorney takes effect immediately once the paperwork is signed.