Pursuant to G. L. c. 201D, one competent adult can appoint another as his or her “health care agent” by executing a health care proxy. The statute requires that the health care proxy be in writing and signed by the principal in the presence of two other adults who witness the execution and attest to the principal’s competency at the time of signing. The person named as the health care proxy has authority to act only after the principal is determined by the treating physician to lack the capacity to make his or her own health care decisions. Once that determination has been made, the health care agent has the authority to make any and all health care decisions that the principal could make for himself or herself, subject to any expressed limitations contained in the health care proxy.
A health care proxy, once it has been given effect by a determination that the principal lacks capacity, may be rendered ineffective by a later determination that the principal has regained capacity or by any act of the principal that evidences a specific intent to revoke the proxy. The proxy is also revoked when a subsequent proxy is executed or when the principal’s spouse had been named the health care agent and the couple are legally separated or divorced.
A health care proxy may contain specific directions concerning particular kinds of treatment that the principal does or does not wish to undergo. While there is still no statutory authority for “living wills,” these stated expressions of wishes or instructions concerning termination or continuation of medical treatment or nutrition under various circumstances can help the agent make decisions in accordance with the agent’s assessment of the principal’s wishes. Living wills should enable health care agents to make medical decisions with the confidence that those decisions are in accordance with principals’ wishes. While these stated wishes can include a “Do Not Resuscitate” or DNR, deference will be given to the agent’s decision in light of the finality of that decision and potential uncertainty of the principal’s intent at the time any DNR comes into play.
The Health Insurance Portability and Accountability Act, also known as HIPAA, was created in 1996 by the US Congress to protect the privacy of your health information. The act prohibits your health care providers from releasing your health care information unless you have provided your health care provider with a HIPAA release form.
Unless you have provided a signed release form, your health care providers are prohibited from discussing any aspect of your medical information with anyone who is not directly involved in your care.