Editorial: Having a health care proxy makes sense

Many people are uncomfortable thinking about the consequences of a catastrophic accident or illness.

Nevertheless, medical experts and religious advisers say it makes sense for all adults to have what is known in Massachusetts as a health care proxy. That is a legal document specifying the person you want to make health care decisions if you become incapacitated.

“Having a health care proxy is an act of responsibility and it’s an act of love,” Ute Schmidt, a chaplain at Baystate Medical Center in Springfield, told Gazette reporter Lisa Spear. “To me it is important to be an agent in our own lives.”

Schmidt, who is in in her 50s and in good health, last year filled out the form authorizing her husband to make health care decision if she is unable.

The two-page form takes only a few minutes to complete and does not require a lawyer to make it valid. Yet between 50 percent 60 percent of people do not have one, says Dr. Diane Dietzen, medical director of palliative care at Baystate Medical Center. “It’s pretty surprising. It is a pretty standard recommendation, but we do a bad job at getting people to understand that they need one.”

Besides the health care proxy, state residents should also consider filling out the Massachusetts Medical Orders for Life Sustaining Treatment (MOLST), another legally binding document specifying whether someone wants to be resuscitated in the event of emergencies such as cardiac arrest or respiratory failure.

Both forms are available online, and links are available from the Massachusetts Medical Society website at www.massmed.org.

The Massachusetts Health Care Proxy Law allows any person age 18 or older to name an agent to make health care decisions in the event that you are unable to do so or to communicate them. That person may act only after your doctor determines, in writing, that you are incapacitated either by temporary unconsciousness, a coma or some other condition.

A proxy with full authority may accept or reject any medical treatment, including that which could keep you alive. That person has the legal right to obtain confidential medical information, and is instructed to act only after consulting health care providers about the diagnosis, prognosis and treatment options for your illness or condition.

The proxy form also allows for an alternate if the primary proxy is not available. The document can be canceled by signing another one later, legally separating or divorcing from a spouse who is named as the agent, or notifying your proxy or doctor that you want it revoked.

Filling out the form is just the first step. Just as important is having a conversation with your primary and alternate proxies so they understand your instructions about treatments. “Help them understand what kind of things are important to you, what kinds of functions are important to you, what kinds of things provide quality of life for you, so that your health care proxy has an understanding of how you would make medical decisions,” Dietzen says.

Although Massachusetts is one of three states that does not legally recognize what is known as a “living will,” attaching it to your health care proxy provides helpful information to the person making decisions for you. You can list in that document, which also is known as a “personal wishes statement,” the specific treatments you would or would not want in the event of a terminal illness, injury, or permanent unconsciousness.

The MOLST, a standard form issued by the state Department of Public Health, is the legal document in Massachusetts regarding resuscitation and instructions for treatments including feeding tubes and dialysis. It must be honored by emergency medical technicians and other health professionals.

It is particularly important for people with major health conditions to complete a MOLST and have it with them at all times, says Karen Jackson, an elder law attorney in Holyoke. “We want it to be as close to them as possible. If they go to the hospital, the MOLST follows them. If they go to the nursing home, the MOLST follows them.”

It makes sense for everyone to specify their instructions ahead of a medical catastrophe. If you do that, it will help put your loved ones at ease that your wishes are being carried out.