Patients & Visitors

Advance Medical Directives

What is an advance medical directive?

It is a legal document that allows you to name someone you know and trust to make your health care decisions if, for any reason and at any time, you become unable to make or communicate those decisions. This person is your "Health Care Agent.”

Types of advance medical directives:

  1. Health care proxy allows you to name someone you know and trust to be your agent and to make health care decisions for you. It can be completed without an attorney or notary.
  2. Durable power of attorney designates a person to act in your behalf to make financial as well as medical decisions. This designation must be notarized.

Who can make out a health care proxy?

Any mentally competent adult 18 years of age or over.

When should I complete a health care proxy?

Now. If you become unable to make decisions, your friends, family and health care providers should understand your choices.

Whom can I name as my agent on a proxy?

You should choose a close family member or friend who will be available to communicate with your caregivers. This person can not be an employee, administrator, or operator of a facility, such as a hospital or nursing home, where you are a patient, unless that person is also related to you by blood, marriage, or adoption.

What should I do with the completed proxy?

Keep the original where it can be found easily (not in a safe deposit box).

Give copies of the completed proxy to:

  1. Your physician
  2. Your agent, and an alternate if your agent is not available
  3. Other close friends or family members

When is my proxy revoked?

  • When you make out another one
  • If your spouse is your agent and you divorce or legally separate
  • When you notify your agent or physician, orally or in writing, that you want to revoke it

What can my health care agent do?

When you do anything that shows clearly that you want to revoke it, i.e., tear it up, destroy it, cross it out, or tell other people that it is no longer valid

  • Make decisions about your health care only when you can't
  • Consent to or refuse any medical treatment
  • Get any medical information necessary to make informed decisions for you

Things to discuss with your agent, to be sure that he or she knows what is important to you:

You should tell your agent your beliefs and wishes regarding:

  • Where you want to receive care
  • What caretakers you want
  • Your family involvement
  • Your religious beliefs
  • Financial concerns
  • When or when not to prolong your life
  • Pain or suffering
  • Organ donations

You should let your agent know your feelings about certain forms of medical treatments, such as:

  • Life-sustaining treatment
  • Cardiopulmonary resuscitation (CPR)
  • The use of intravenous therapy and/or feeding tubes to administer food, water or medicine
  • Breathing machines
  • Kidney dialysis

When can my agent make decisions for me?

When your physician decides, in writing, that you are unable to make decisions about your health care, and after considering fully all medical information about your condition.

When you are admitted to Nantucket Cottage Hospital, you will be asked:

  1. If you have a health care proxy
  2. If you want information about the proxy
  3. If you want to complete a proxy
If you have completed a health care proxy, you should bring a copy of it to the hospital. It will be placed in your hospital record. If you have made changes to your proxy, you should bring the new copy.

Where can I get a health care proxy form?

Nantucket Cottage Hospital's Admitting Office.

Nantucket Cottage Hospital is an affiliate of Massachusetts General Hospital and a member of Partners HealthCare.