Who Speaks for You? Choosing a Health Care Proxy with Confidence
- Meghan Maher, MPH, CEOLD
- Apr 8
- 4 min read
If you were unable to speak for yourself during a medical crisis, who would you want to make decisions on your behalf?
For one in three adults in the U.S., that question remains unanswered. Without a designated health care proxy, family members and medical teams are often left guessing—or defaulting to decisions that may not reflect your values or wishes.
Choosing a health care proxy isn’t just filling out a legal document. It’s a deeply personal act of care - one that ensures your voice is heard even when you cannot speak. Whether you're facing a routine surgery, an unexpected illness, or long-term planning for the future, having a trusted person ready to speak for you can bring clarity and peace of mind when it matters most.
What Is a Health Care Proxy?
Identifying a health care proxy, also called a health care surrogate or medical power of attorney, is the legal process of naming someone you trust to make health care decisions on your behalf if you're ever unable to make them yourself. This person steps in during times of serious illness or injury to ensure that your care aligns with your values and goals.
It’s part of a larger category of documents called advance directives, which guide your medical care if you're unable to communicate. Your proxy, or agent, can make decisions that align with your wishes; this helps your health care team understand exactly what matters most to you.
Why Naming a Surrogate Matters
When no surrogate or proxy is named, medical decisions often fall to loved ones who may be overwhelmed, unsure, or in disagreement. Here's how a health care proxy can change the picture:
With a Proxy | Without a Proxy |
Decisions are made based on your clearly expressed values and what you would want if you could make the decision yourself. | Families may struggle to interpret your wishes or disagree with each other. |
Providers follow your treatment preferences with clarity. | Health care providers may rely on standard protocols that don’t align with your goals. |
Your loved ones aren't left guessing. | Your voice may be lost at a critical time. |
A health care proxy provides clarity and comfort - protecting your autonomy and easing the burden on those who care about you.
How to Choose a Health Care Proxy
Each state has its own requirements for creating advance directives and appointing a health care agent. Generally, the process includes:
Filling out a state-approved form (often called a Health Care Surrogate or Proxy form or Durable Power of Attorney for Health Care).
Naming your agent and an alternate in case your first choice is unavailable.
Specifying your preferences around medical treatments, life support, and comfort care.
Signing the form in front of witnesses or a notary, as required by your state.
Once completed, give a copy to your agent, your doctor, and your care facility, if applicable. Review your documents regularly, especially after major life changes.
How to Choose the Right Person
Selecting your health care proxy is a deeply personal decision. Look for someone who:
Knows you well and understands your values and beliefs, especially around quality of life and end of life care.
Can make calm, thoughtful decision maker under pressure.
Will advocate for your wishes - even if others disagree.
They don’t need to be a medical expert. What matters most is their ability to listen, understand, and speak up for what matters to you.
Start the Conversation
Talking about your preferences with your chosen proxy can feel daunting - but it’s one of the most important conversations you’ll ever have. Talk with your agent - your proxy needs to know that they are your proxy!
Resources like The Conversation Project can help guide these discussions. You can also visit The Conversation You’ve Been Putting Off, and How to Start It for a deeper look at how and why to start the conversation.
Consider covering:
What quality of life means to you.
Whether you’d want life-sustaining treatments in specific situations.
How you feel about pain management, comfort care, or hospice.
What kind of medical interventions align with your values.
These conversations don't have to happen all at once. Start small, and revisit them often.
Keep the Dialogue Going
Your wishes for the type of medical care you do or don't want may change over time. It’s a good idea to:
Revisit your advance directives every 1-2 years.
Update your documents after major life events, like a new diagnosis or a move.
Make sure the person you choose remains willing and available to serve in this role.
Encourage open communication. Ask your proxy if they have any questions or need clarification. Make sure they have a copy of your directives and know where to find the original.
Life Changes? Update Your Advance Care Plan
Life evolves - and your care preferences might, too. Whether it’s a health event, a change in relationships, or a shift in your values, be sure to keep your proxy and documents up to date.
Life Event | Action |
Diagnosis or health crisis | Review and possibly revise your preferences |
Move to a new state | Complete new forms compliant with state laws |
Relationship or contact changes | Update your agent and provide current contact info |
You can change your proxy at any time. The key is making sure the person speaking for you truly reflects who you are today - not who you were five years ago.
A Living Voice for Your Care
Your health care proxy and advance directives are living documents. They aren’t about locking in one plan forever. They’re about making sure your values continue to guide your care, no matter what happens.
Take time for decision-making now. Naming a trusted person to make your medical decisions, and having meaningful conversations is an act of love - for yourself and for those who may one day need to speak on your behalf.
As National Healthcare Decisions Day approaches, make this the week you take that step. Your voice matters. Let it be heard - even when you can’t speak.
If you’re not sure where to begin or you’d like someone to walk with you through this process, I’m here to help. Contact me for compassionate, knowledgeable support in making these decisions with clarity and confidence.
