Dr. Mehmet Oz answered:If you are someone's designated health care proxy, it can be emotionally wrenching because you're dealing with our own grief, sadness, and fear while trying to be strong and responsible. But you may also feel fortunate that you're there to help. I can assure you that this will almost always be one of the most poignant journeys of your and your loved ones' lives.
The info you need depends on how large a role you will have as that person's proxy, whether you're an immediate relative, and how much control is granted to you. Asking the following questions will help you determine where you stand and will also give you specific ideas on what you'll need to talk over with other family members, the person's doctor, hospital social workers, and an attorney.
Find out more about this book: YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatmen...If you are someone's designated health care proxy, it can be emotionally wrenching because you're dealing with our own grief, sadness, and fear while trying to be strong and responsible. But you may also feel fortunate that you're there to help. I... More
- What's the person's diagnosis and prognosis?
- How certain is the answer to the above question? What are the odds of a partial or full recovery? Because predictions are often wrong, you don't want family members to start vying for possessions prematurely.
- Has the person prepared and signed advance directives? (If the person has not, and he or she is able to, for Pete's sake try to get it done! This could save you tons of stress and hassle.)
- Has the person spoken with any close friends or relatives about what his or her wishes would be in the event of an incapacitating injury? Hopefully you'll be the one they spoke to, but if not, better to find this out now rather than later.
- Does the hospital have a social worker, ethics committee, or other staff members to help you consider the available options for care?
- What kinds of financial assets does the person have? No, you're not snooping (well, that shouldn't be your motivation); you need to know this in case you have to answer questions about what type of care they can afford and their eligibility for programs like Medicaid.
- Does the person have medical, long-term care, or Medicare insurance that will cover the cost of hospital or long-term illness care? It's always a happy occasion when they do. (If you don't, you can read the preceding sentence as a recommendation to look into long-term care insurance and other provisions, so you'll cause a happy occasion if that question comes up in your case one day.)
Dr. Katrina Bramstedt answered:
If someone asks you to be their proxy (also known as a surrogate decision-maker or durable power of attorney for healthcare) one of the most important things to ask yourself is, "Can I honor the treatment wishes of the patient?"
The duty of a proxy is to uphold the written or spoken wishes of the patient when the patient cannot speak for him/herself because of severe illness. Sometimes, this can be very challenging because the values of the proxy/surrogate might not concur with those of the patient. For example, the patient might have expressed values indicating the preference of never wanting to live in a nursing home on life support in a permanent coma; but, the proxy, does not support that view and is personally ethically distressed about any decision-making that would not allow such a life plan.
If you are asked to be a proxy, talk with the requestor and ask them about their health care values and share with them YOURS. Before you agree to be their proxy, be certain you can uphold their ethical values about life, health, healthcare, and dying. If you agree, be sure to get a copy of the person's living will (Advance Directive) and keep it in a safe place that you can easily access when you need it.
If you would like to write a living will for yourself, go to www.TransplantEthics.com and use the free template (a pdf form). Give a copy to your personal doctor and to each of your surrogate decision-makers.
If you would like more information about medical decision-making, read my book, FINDING YOUR WAY: A MEDICAL ETHICS HANDBOOK FOR PATIENTS AND FAMILIES.If someone asks you to be their proxy (also known as a surrogate decision-maker or durable power of attorney for healthcare) one of the most important things to ask yourself is, "Can I honor the treatment wishes of the patient?" The duty of a... More
If someone asks you to accept responsibility for being their surrogate decision-maker in health care decisions, consider the charge carefully before you accept. Apply these qualities to yourself and try to be objective in your answers.
- Do I know the person well enough to understand their values and beliefs? Can I articulate accurately how they personally balance the quality of their life with its absolute quantity?
- Am I able to adapt to their understanding of unforeseen circumstances? Could I take the principles they live by and apply them to a situation they may never have spoken of specifically? This is a quality of abstract thinking. Can I understand a broad principle and apply it to a specific set of facts?
- Do I care for them enough to be passionate about honoring their wishes?
- Might grief cloud my judgment? As you can imagine, numbers 3 and 4 require a balance. Your grief should not elicit hysteria or disordered thinking.
- Can I be strong in the face of medical authority and attempts to influence my decision? Often doctors have very specific ideas about appropriate treatment. Their influence can be subtle: “I doubt your loved one meant to refuse a feeding tube as a life-sustaining treatment.” And it can be downright coercive: “If that is your decision, we will be forced to notify the authorities at the state protection agency.” Calm thinking and resolute decision-making are important qualities in a surrogate decision-maker.
- Do I have the respect and affection of others close to them? If they have a large family, someone might question or doubt whether a decision is correct. You will have an easier time if others know you as a loving, compassionate and intelligent thinker.
If you believe you would do the job well, consider it a great honor to be asked, and accept with respect and compassion.If someone asks you to accept responsibility for being their surrogate decision-maker in health care decisions, consider the charge carefully before you accept. Apply these qualities to yourself and try to be objective in your answers. Do I know... More