A breast cancer diagnosis is a life-changing event that can alter the way you think about your future. Cancer often brings life into perspective and can stir up issues that you may not have thought about, including who will take over your medical decisions if your health declines.

Many people struggle with advance care planning, such as creating a living will or filling out advance directives. Planning for your future ensures that your wishes are fulfilled and gives your loved ones guidance in the face of challenging medical decisions.

Some members of MyBCTeam have decided to take care of their paperwork before procedures, like one member who wrote, “Getting my living will/power-of-attorney documents ready before surgery on Tuesday.”

Others were prompted to think about the future by observing the hardship that friends and relatives face when paperwork isn’t put in place. “In light of my brother’s recent cardiac bypass surgery, I wanted to reemphasize the need to have your legal documents in order before a sudden life-altering event occurs,” said one member. “No DNR, no power of attorney for health care, and no general power of attorney, no will. My brother’s entire estate is at risk for probate proceedings. His wife is now saddled with the extra burden of getting these documents signed and notarized immediately. So much stress and financial hardship can be avoided if these legal steps are taken before the need is critical. Please make it a priority before it is too late.”

Regardless of your age or whether you have the benefit of early detection with a good prognosis, designating a medical power of attorney can be a good idea. Familiarizing yourself with the process can help you choose the best person for this important role.

What Is a Medical Power of Attorney?

A medical power of attorney, sometimes called a durable power of attorney for health care, is a legal document that gives another person the ability to make medical decisions on your behalf if you’re unable to make your own decisions. In the United States, there are specific state laws for setting up a medical power of attorney. The person you choose may be referred to as your:

• Health care agent
• Health care proxy
• Health care surrogate
• Health care representative
• Health care attorney-in-fact
• Patient advocate

A medical power-of-attorney agent must follow any predetermined guidelines that you specify. However, this person can make significant decisions, including whether to keep you on life support, move forward with certain treatment options, or discontinue medical treatment and opt for palliative care only.

Potential Benefits and Risks

Choosing a medical power-of-attorney agent can reduce the burden on your loved ones if you have a health emergency. Having a trusted person who can act as your advocate will help inform and guide your health care team.

By making decisions in advance — or choosing someone who understands what you want — you can prevent others from grappling with difficult choices or having doubts and regrets. Be sure to inform the person you choose as your agent so they can be prepared and available if called upon. Let your other loved ones know your reasoning for choosing this person and encourage them to support your agent in fulfilling their decision-making responsibilities.

As one MyBCTeam member shared, “I just attended a course through Gilda’s Club about advance directives. It included information on post-death decisions. I have decided to work on mine now. The other documents I still need to get info on are power of attorney and will/trust documents.” They continued, “I want to be sure there are no doubts as to my wishes. It is incredibly important to let others know so that they can enact those wishes and give you peace of mind.”

If you don’t choose a medical power-of-attorney agent, one may be chosen for you. The following people are legally authorized to make decisions about your health care (in the order listed) if you can’t make those decisions:

• Any guardians or conservators previously appointed by a court
• A legal spouse or domestic partner
• An adult child
• An adult sibling
• A caregiver (who is not your health care provider)
• A close friend or nearby relative

If you want to prevent any of the above people from having power over your care, you can put paperwork in place to specify that wish. Designating a medical power-of-attorney agent ensures that your preferred person or people will be in charge if needed.

Some risk is always involved when you give another person legal authority over your rights. However, medical power of attorney doesn’t come into play unless a doctor verifies your inability to make health care decisions first. You can also set limits on the types of decisions your agent can make for you, and the agent is required to follow the instructions you’ve provided. If a court believes that your health care agent is not acting in your best interests or per your previously designed desires, the right of medical power of attorney can be revoked.

Choosing the Right Person

State laws can vary, but in general, a person must meet a few criteria before they can be given medical power of attorney. For example, your agent must be older than 18 years of age or legally emancipated. The person can’t be your health care provider or someone related to your health care provider.

Examples of the people who are typically appointed to be health care agents include:

• A close friend
• A family member
• A member of your religious community
• A trusted neighbor

One member of MyBCTeam talked about having her son as her appointed agent: “Well, I’m at the hospital, all checked in and being prepped for surgery. I talked to my son last night and told him about the surgery, made him aware of the risks, and made sure he was OK with me having it. He’s OK with everything. He knows he’s on my advance directive, and I know he wishes he was here for me.”

There’s a lot to consider before signing a medical power-of-attorney document, including whether you feel the other person is up to the task. Just because someone cares for you doesn’t mean they are the best choice to act as your representative. Be sure to steer clear of anyone you don’t feel can handle the responsibility that comes with having decision-making authority.

Ideally, you should choose a medical power-of-attorney agent before your health comes into question. Because circumstances may change over time, you have the right to change your agent or revoke their rights as long as you’re still capable of making your health care decisions. For instance, a spouse who was given the power of attorney may have this right removed if a divorce occurs. Be sure to read through the terms or meet with a lawyer or social worker who can help explain the ins and outs of your medical power-of-attorney document before signing it.

How Do You Complete the Process?

For most parts of the United States, there’s a simplified form you can use to designate your health care agent. This bare-bones multistate form is valid in every state except Ohio, New Hampshire, Texas, and Wisconsin. Each of these other states has its own mandatory disclosure statement for the same purpose.

You should be able to find medical power-of-attorney forms on your state government’s website. Most states don’t require a notary, but typically two witnesses must be present to certify that you signed the forms. Different states have specific rules on who can serve as a witness, so be sure to read the terms carefully or seek legal counsel to help you.

While selecting a medical power-of-attorney agent, you may also want to put other legal documents in place that define the type of medical treatment you want, how your bank accounts will be managed, and who will care for your children (if applicable). Ask your oncology provider for a referral to an attorney who can help you with the process.

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer, survivors, and their loved ones. More than 54,000 members with experience in breast cancer gather to ask questions, give advice, and share their experiences with others who understand.

Have you designated a medical power of attorney? What prompted you to take this step and how did you choose the right person? Share your insight in the comments below, or start a conversation by posting on MyBCTeam.