What You Need to Know About Medical Decision Documents
Planning for incapacity is just as important as planning for what happens after death. Below are answers to the most common questions about healthcare powers of attorney, living wills, and HIPAA authorizations.
1. What is a Healthcare Power of Attorney?
A Healthcare Power of Attorney (also called a Medical Power of Attorney) is a document that allows you to appoint someone to make medical decisions for you if you cannot make them yourself.
This person is called your:
- Healthcare agent
- Medical agent
- Healthcare proxy
They step in only if you are incapacitated.
2. What is a Living Will?
A Living Will is different from a regular Will.
It outlines your wishes regarding life-sustaining treatment in situations such as:
- Terminal illness
- Permanent unconsciousness
- End-stage medical conditions
It provides guidance about:
- Life support
- Artificial nutrition and hydration
- Resuscitation
- Other end-of-life decisions
3. What is a HIPAA Authorization?
HIPAA is a federal privacy law that protects your medical information.
A HIPAA Authorization allows specific individuals (such as your healthcare agent) to access your medical records and communicate with doctors and providers.
Without this authorization, even close family members may be denied access to your health information.
4. Why Do I Need All Three Documents?
Each document serves a different purpose:
- Healthcare Power of Attorney → Who makes decisions
- Living Will → What decisions you want made
- HIPAA Authorization → Who can access your medical information
Together, they create a complete incapacity plan.
5. When Do These Documents Take Effect?
Typically:
- The Healthcare Power of Attorney becomes effective when you are unable to make decisions yourself.
- The Living Will applies when you are in a qualifying medical condition.
- The HIPAA Authorization allows access to records as outlined in the document.
You remain in control as long as you are mentally competent.
6. Can I Choose Anyone as My Healthcare Agent?
In most cases, yes — as long as the person is:
- An adult
- Mentally competent
- Willing to serve
You should choose someone who is:
- Calm under pressure
- Able to communicate clearly with medical providers
- Willing to follow your wishes, even in difficult situations
7. Should I Name Backup Agents?
Yes.
Life changes. The person you name today may not be available in the future. Naming at least one alternate agent is strongly recommended.
8. Why Do Psychotherapy Notes Require Separate Authorization?
Federal law gives psychotherapy notes special protection because they contain highly sensitive information. A general HIPAA release does not automatically include them. You must specifically agree if you want those records accessible.
9. Can My Agent Override My Wishes?
No.
Your Healthcare Power of Attorney requires your agent to follow your expressed wishes. The Living Will provides written guidance. Your agent is legally obligated to act in your best interest.
10. What Happens If I Don’t Have These Documents?
Without these documents:
- Doctors may look to next of kin under state law
- Family members may disagree
- Court involvement may be required
- Delays in care decisions may occur
In some cases, a guardianship proceeding may be necessary.
11. Can I Change or Revoke These Documents?
Yes.
As long as you are mentally competent, you may:
- Update
- Replace
- Revoke
your healthcare documents at any time.
12. Do These Documents Expire?
Generally, no. However, it is wise to review them every 3–5 years or after major life events such as:
- Marriage or divorce
- Death of an agent
- Relocation to another state
- Major health changes
13. Do I Still Need These If I’m Young and Healthy?
Yes.
Incapacity can occur unexpectedly due to:
- Accidents
- Sudden illness
- Surgery complications
Every adult over 18 should have basic healthcare planning documents.
The Bottom Line
Healthcare planning ensures that:
- Someone you trust can make decisions for you
- Your medical wishes are honored
- Family conflict is minimized
- Court involvement is avoided
It is one of the most important — and often overlooked — parts of estate planning.
