Healthcare Surrogates

A healthcare surrogate, or medical proxy is the person you name to advocate for your medical wishes and make healthcare decisions for you if you are unable to do so.

Considerations

What should you consider when choosing a healthcare surrogate?
  1. The person you choose to represent you should be someone you trust who is at least 18 years of age.
  2. They can be your spouse, next of kin, or another family member.
  3. Your healthcare surrogate does not have to be a family member—it can be a friend, a member of the clergy, a neighbor or a professional who specializes in serving individuals in this way.

Be aware that you cannot appoint your primary care physician or any other healthcare practitioner involved in your care, unless they are related to you by blood, marriage or adoption. 

You should consider naming an alternative representative or two to step in if your primary representative is not available. Once you’ve chosen someone, make sure those close to you and your doctor or healthcare provider knows who you have chosen to represent your interests.

Considerations when choosing a healthcare surrogate:

  • Are they assertive? You want someone who is comfortable speaking with healthcare providers and advocating for you.
  • Are they comfortable talking about death? They will need to speak openly about death and dying.
  • Do they live nearby? When a health crisis occurs, having someone local can be important.
  • Will they respect my decisions? They need to understand where you’re coming from and be willing to honor your requests.

Early conversations matter. 

Talk about your preferences regarding the extreme measures doctors might use to prolong your life. Before naming your healthcare surrogate, make sure they are comfortable with and clearly understand your choices. When discussing your request, let them know there is no financial liability attached to this role.

advance directive

Durable Power of Attorney for Healthcare Decisions

The key difference of a durable power of attorney for healthcare decisions from other types of surrogates is that it endures even after you have become incapacitated. In other words, you want to authorize a durable power of attorney if:

  • You want to give the person authority only if you are unable to act for yourself; or
  • You want to give the person immediate authority that continues after you are unable to act for yourself.
For instance, if you have been diagnosed with early stage Alzheimer’s, you would want to designate a durable power of attorney who can begin to act – or continue to act – on your behalf when the disease progresses and you are unable to act on your own.

Access to Medical Records

The best way to avoid an inability to access medical information and/or decision-making disputes is through the execution of an advance directive, where you will name appropriate agents (health care surrogate) and authorize the release of medical records to such designated persons. 

Your surrogate will have the authority to make all health care treatment decisions. They must be provided access to your medical records and information regarding medical conditions and prognoses. Additionally, your surrogate becomes your “Personal Representative” under HIPAA, which entitles the surrogate to the same rights as you, the patient, as it relates to disclosure of medical records and information. 

In addition, you or your health care surrogate can complete a HIPAA Release Form (see below) to designate others who may have access to your medical records and information,

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Medical Information Release Form

(HIPAA Release Form)

A HIPAA Release Form is a document that allows the release of your medical records which are protected under HIPAA (the Health Insurance Portability and Accountability Act). On the form you, or your health care surrogate, provide the name(s) of designated representative(s) who are permitted to receive your medical records and health information. A HIPAA Release form can be revoked or reassigned at any time by the patient.  
Updated March 23, 2024

RESOURCES:

An important step in having the conversation about your wishes for care through the end of life is choosing a health care proxy (also known as a health care agent, power of attorney for health care, or surrogate decision-maker). The Conversation Project offers tools on how to start the conversation and resources guides on how to choose or how to be a Health Care Proxy. GET STARTED HERE.