Advance Directives

Advance planning provides peace of mind for you and your loved ones

Communicate Your Healthcare and End-of-Life Wishes

Most people do not want to burden their family with tough decisions. Yet few have communicated their end-of-life wishes to their loved ones. It’s a tough conversation to have, but it’s also vitally important.

Learn more about your options and how to get that conversation started.

Advance Directives

An advance directive communicates your wishes for the care you'd like to receive if you become too sick to make health decisions on your own. You can outline in advance what kinds of treatments you do or don't want.

While advance directives are useful, they can't cover every situation that comes up or every decision that needs to be made. That's why naming a healthcare proxy is important. A proxy is a person you appoint to make these decisions for you — the proxy becomes your voice when you can't speak for yourself.

In Massachusetts, if you cannot make or express your own healthcare decisions, a completed healthcare proxy form is the only legally binding document related to your healthcare. That's why it's so important to plan in advance.

Getting Started

It's time to start the conversation. Beth Israel Deaconess Hospital–Plymouth offers resources from The Conversation Project. The Conversation Starter Kit provides a roadmap for how to best approach loved ones and address end-of-life wishes.

Healthcare Proxy and Advance Planning

Learn more about choosing a healthcare proxy and download the form.

You can also access our Patient and Family Guidebook to learn more about advance directives, healthcare proxy and end-of-life planning.

For more information, you may also speak with a member of your healthcare team, including your doctor, nurse, social worker or chaplain.

Frequently Asked Questions

What is a healthcare proxy?

A healthcare proxy (sometimes called a healthcare “agent”) is someone who can be your voice if you’re ever unable to make or express healthcare decisions yourself. It’s up to you to pick your healthcare proxy. This person can make sure your care providers know what matters to you if you become unable to speak for yourself.

It’s never too soon to choose a proxy. Everyone 18 years of age and older — people who are healthy as well as those who are sick — should complete a healthcare proxy form. Many serious health problems come up unexpectedly. Think of the proxy as a type of insurance: You hope you never need it, but if you do, it’s important that you’re prepared.

Whom should I choose as my proxy?

Your healthcare proxy should be someone who understands and respects your values and wishes regarding your health. They also should be someone willing and able to communicate those values and wishes to your healthcare providers, even if this is difficult. It is often a spouse or a close family member, but it doesn’t have to be. You are free to name almost anyone you choose as your proxy.

There are only a few rules about people you may not name:

  • You may not name someone under 18 years old.
  • If you are currently a patient at a healthcare facility, you may not name an employee of that facility as your agent (unless the person is a relative).
  • You may not name a member of your current care team. For example, a doctor or nurse cannot provide care for you and serve as your proxy at the same time.
How do I assign a healthcare proxy in Massachusetts? Do I need a lawyer or a notary?
No. A Massachusetts Healthcare Proxy Form can be filled out any time. You do not need a lawyer or notary. Also, the person you name as the proxy (or alternate) does not need to be present and does not need to sign the form.
Do I need a witness?
Yes. For the form to be complete, it must be signed by you (or your authorized representative) and witnessed by two adults. The witnesses cannot be the proxy or alternate proxy. Ideally your witnesses should be people you know. But if needed, hospital staff may serve as witnesses. (If they do, they should give their work address on the form.) A photocopy of the form is just as valid as the original.
Do I need a healthcare proxy is I have a living will or have otherwise expressed my wishes?

Yes. A healthcare proxy isn’t the same as a living will or other forms people may use to outline their wishes. While living wills and other planning forms are useful tools, they cannot cover every situation that may arise or every decision that may need to be made.

That’s why having a proxy is so important. The proxy can be your voice and can speak for you no matter what healthcare decision needs to be made. Also, in Massachusetts, if you cannot make or express your own healthcare decisions, a completed healthcare proxy form is the only legally binding document regarding your health.

May I have more than one person as my proxy?
In Massachusetts, you may name one 'primary' proxy and an 'alternate' proxy. The alternate person would only step in if your primary proxy was unavailable or was unable or unwilling to serve.
Can family and friends who are not my proxy also be involved in my healthcare decisions?

Yes. A larger circle of family and friends can be involved in decisions about your care. In fact, people who are close to you might be extremely helpful if your proxy needs to make difficult choices about your care. Talking to your proxy about who should be part of this process is important. Still, in the end, your healthcare team will look to your proxy to speak for you.

If a family member doesn’t agree with care plans that are being made or believes that your proxy is not carrying out your wishes, he or she may go to court to legally challenge your proxy’s decisions.

When does the proxy make decisions for me?
Your proxy makes decisions for you only after your doctor has said that you aren’t able to make or express decisions about your care. This is done based on standards of medical practice. Once your proxy begins making decisions for you, your proxy will have access to any medical information that you would have access to yourself. Your proxy speaks for you only if you are unable to communicate your wishes. If your doctor says that your ability to speak for yourself has returned, your proxy no longer speaks for you.
What if I change my mind about who my healthcare proxy should be?

You may change your mind at any time. Be sure to tell your healthcare team about the change. Your signed proxy form will be cancelled if:

  • You fill out a new form later.
  • You legally separate from or divorce your spouse, and your spouse was named as your agent. (If you wish to use that person as your proxy, you may do so if the form naming them as your proxy was completed after your separation or divorce date).
  • You tell your agent, doctor or other healthcare provider — verbally or in writing — that you changed your mind about your proxy.
What happens if I don't have a healthcare proxy?

You don’t need a healthcare proxy to receive care. But if you don’t have one, your healthcare providers will automatically turn to your family for guidance regarding your wishes. If you haven’t told them what you would want in a particular situation, they will be left to guess. This may be a difficult burden for them, and they may not make the decisions you would want them to make. You can help prevent your loved ones from suffering unnecessary stress and anxiety by selecting a proxy and having a conversation ahead of time about your care.

Also, if you don’t have a healthcare proxy, certain decisions about your care may need to be addressed in court. For example, this may happen if your family cannot be reached or disagrees about the course of your care. Also, nursing home placement cannot occur without a proxy or court-appointed guardian.

What happens if I go to a hospital other than BID Plymouth?
If you go to another hospital in Massachusetts and you have a copy of your proxy form, you don’t need to fill out a new form. If you go to a hospital in another state, your proxy form will be honored in most cases.