Who’s Your Medical Proxy?

Or can it be that you don’t have one? Only one in four of us have been asked to identify a medical proxy or surrogate in the course of medical care, although over 90% think it’s a good idea. So it’s quite possible that you may have reached the baby boomer age without having designated a surrogate, or medical proxy.

Suppose you are delivered to hospital after an accident or a sudden incapacitating illness (heart attack, stroke), who would you like to take important health decisions for you? For example, to operate or not, to transfer to a specialist center or not, to remove a limb or not? If you haven’t designated a proxy, and made this know to your family doctor and/or next of kin, the treating physician will probably turn to your spouse, or parent, or child, whichever is nearest.

A new survey of married people has shown that one-third of them would choose someone other than their spouse as medical proxy. And, more often than not, when adults chose a parent, sibling, or child, they prefer their mothers, sisters or daughters over their available close male relatives. This suggests that, in the absence of a clearly recorded selection, people run a 50% chance of having someone not their first choice taking important health decisions on their behalf. Something to think about.

By the age of 40, or maybe 45, everyone should have a designated medical proxy or surrogate, along with other advance directives, including a ‘living will’. These will cover your wishes concerning such things as artificial feeding if you’re unconscious, and ‘do not resuscitate’ orders to the nursing staff, if that’s likely to be your wish. It may sound macabre to think of these things when you are well, but it’s quite possible to go from well to desperately ill in a very short time. So, you must act in time.

Health professionals, and your family doctor in particular, should be offering to guide you through the advance directives and proxy paperwork. You just have to ask them, sometimes.