A Massachusetts (MA) health care proxy is a document that lets you select someone to make healthcare decisions on your behalf if you lose your decision-making ability. The person you choose (called your agent) is required by law to carry out your wishes for medical treatment and act in your best interest.
A Massachusetts health care proxy can also be referred to as a:
- Massachusetts Durable Power of Attorney for Health Care
- Health Care Proxy Form MA
Laws: Chapter 201D of the Massachusetts General Laws govern health care proxies in Massachusetts, including the agent’s responsibilities and how to create or revoke the document.
Download a Massachusetts Health Care Proxy Form
Download: Word (.docx) or Adobe PDF
In addition to your health care proxy, consider adding the following documents to your end-of-life plan:
- Living Will: In this document, you describe your preferences for specific medical treatments in case you become unable to communicate. Living wills and health care proxies (medical powers of attorney) are both types of advance directives.
- Massachusetts Power of Attorney: This document lets you appoint an agent to handle your financial affairs, especially if your doctor decides you’re too sick to manage your own affairs.
How to Fill in a Health Care Proxy in Massachusetts
Take these steps to make sure your health care proxy is legally binding according to the requirements outlined in M.G.L. ch. 201D.
Step 1: Choose an agent
Your agent is responsible for making important healthcare decisions on your behalf if you can’t communicate your wishes.
Who should you choose as an agent?
Your agent must be at least 18 years old and should understand your personal beliefs and values. They may have to make difficult, personal decisions on your behalf, so it’s important to choose someone you trust.
Relevant law: M.G.L. ch. 201D § 2
Who can’t be your agent?
Your agent can’t work at the healthcare facility (like a hospital or nursing home) where you’re receiving treatment unless you’re related to them by blood, marriage, or adoption.
Relevant law: M.G.L. ch. 201D § 3
Can you have more than one agent?
Yes, you can select an alternate agent in case your primary agent isn’t able to fulfill their duties.
Relevant law: M.G.L. ch .201D § 2
Step 2: Specify what healthcare decisions your agent can make
Carefully consider what powers you want to give your agent as you create your health care proxy.
Can you limit your agent’s powers?
Yes, you can describe any limits you want to place on your agent’s powers in your health care proxy. If you don’t limit your agent’s powers, they will have full authority over your medical affairs, including:
- Deciding whether to withhold life-sustaining treatment
- Accessing your medical records to make decisions about your health care
- Admitting or discharging you from a healthcare facility
- Donating your organs and tissues
To restrict your agent’s ability to make certain decisions on your behalf, simply write out instructions, for example, “I do not want to receive artificial hydration or nutrition.”
Relevant law: M.G.L. ch. 201D § 5
What is your agent legally unable to do?
Massachusetts law prevents your agent from making any decision that goes against your wishes or isn’t in your best interest. Doing so could give the court grounds to remove them as your healthcare agent.
Relevant law: M.G.L. ch. 201D § 5 and M.G.L. ch. 201D § 17
When can your agent start making decisions for you?
Your health care agent can make decisions for you only after your physician provides the following people with written and verbal confirmation that, according to medical standards, you’re unable to communicate health care decisions:
- You (if you’re able to comprehend)
- Your agent
- The director of your mental health facility (if applicable)
Even if your doctor decides you’re unable to make medical decisions, you still have the power to object to a decision your agent makes on your behalf unless a court order determines you to be incapacitated.
Additionally, your agent will lose their power to act on your behalf if your doctor decides you’ve regained the ability to communicate healthcare decisions.
Relevant law: M.G.L. ch.201D §6
Step 3: Sign the form
Sign your health care proxy according to Massachusetts requirements to make sure it’s legally binding.
Do you need witness or notary signatures?
Your health care proxy needs to be signed in the presence of two witnesses. If you physically cannot sign, you can direct someone to sign for you. Your witnesses must be at least 18 years old, of sound mind, and able to confirm that you’re signing willingly.
Relevant law: M.G.L. ch.201D §2
Who can’t be a witness?
The person you choose as your agent can’t serve as a witness.
Relevant law: M.G.L. ch.201D §2
How long is your Massachusetts health care proxy effective?
Your health care proxy is valid indefinitely, unless you decide to change or revoke it.
How to Revoke a Massachusetts Health Care Proxy
Unless a court order determines you can no longer make decisions for yourself, you can revoke your health care proxy at any time by taking one of the following actions:
- Tell your doctor (or anyone administering your health care) that you want to revoke your health care proxy
- Create a new health care proxy with different terms
- Write a revocation of power of attorney form and share a copy with your physician or your agent
If your spouse is your agent, getting a divorce or legally separating from your spouse automatically revokes your health care proxy.
Relevant law: M.G.L. ch.201D §7
