The Complexities of Health Care Proxies – Part I

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Juhan Sonin_PicThere is a push to encourage everyone to sign a health care proxy. For good reason. Medicine is increasingly able to prolong life, but not always quality life.  Over treatment and under treatment concerns abound.  People should designate someone they trust – a health care proxy – to articulate what interventions they want in life threatening situations, should they be unable to speak for themselves.

While the concept of  health care proxies is straightforward, their successful use is another matter. Proxy papers get lost. The designated proxy is not available or does not know the wishes of the patient. Loved ones challenge the directives. Hospitals are unable to locate proxies that have been filed with them.

This topic has many complexities.  This article  focuses on one of the basic issues: making sure your health care proxy is easily found when needed.

A Health Care Proxy is No Ordinary Legal Document

Although many people consider a health care proxy to be a legal document, it should not be filed where people typically store important legal documents, such as a safe deposit box or your attorney’s office. A health care proxy is your effort to communicate your treatment choices to health care professionals in an emergency or time sensitive situation.   You should keep your health care proxy where  it can be easily found.

A Health Care Proxy Should be Filed in Multiple Places

Many people think that they need only have the original of their health care proxy. Not so! Because people cannot anticipate the circumstances that may require use of their health care proxies, it is best to keep copies where they can be easily retrieved in a variety of circumstances. Here are some suggestions:

  • With your proxy (and any substitutes)
  • With your primary care and specialist physicians
  • In the glove compartment of your car
  • In plain sight in your home, such as the refrigerator
  • In your purse
  • In your briefcase

There are now many ways to maintain an electronic version of your proxy as well:

  • On a UBS flash drive that you attach to your key ring
  • In an email to yourself or your proxy as an attachment
  • In a cloud service, such as Drop Box
  • On a smart phone, using one of the many apps that are now in use, such as  myhealthcare, DocuBank, mydirectives, EverPlans,  or Aftersteps.

A note a caution about electronic forms. Although they are considered to be immediately retrievable, they are not accessible if you are unconscious and no one knows the password.  A smartphone is useless if its battery is dead, or it  is lost.  Hence the need for multiple copies.

The Simplicity of a Wallet Card or ICE app

Nothing is fool proof.  A good backstop is the simple wallet card or ICE app (in case of emergency). A wallet card can provide the name and phone number of your proxy or next of kin, which is a good start.  The ICE app allows someone to get emergency contact numbers from a cellphone without any passwords. By taking the time to place copies of your proxy in places that you think are secure and known to others, you have greatly increased the likelihood that your preferences will be honored should the need arise.


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