Massachusetts Health Care Proxies Explained: Who Will Make Decisions If You Can’t?
As estate planning attorneys serving Gloucester, Rockport, Manchester by the Sea, Beverly, and the entire North Shore of Massachusetts, we regularly advise clients on one of the most overlooked but vital documents in any estate plan—the health care proxy. A health care proxy is not just for the elderly or the seriously ill. Every adult in Massachusetts should have this document in place, because none of us can predict when a medical emergency might render us unable to communicate.
We’ve helped families across Essex County deal with the consequences of not having a health care proxy in place. When a person is suddenly incapacitated and there’s no legal authority given to a trusted agent, families are often left with uncertainty, conflict, and delays in medical care. Massachusetts law allows adults to choose who will make health care decisions if they lose capacity, but the decision must be made ahead of time and documented correctly.
Without a valid health care proxy, doctors may be left making critical choices without clear guidance from the person’s loved ones. Worse, families may be forced to go to court to establish a guardianship. That process is time-consuming, costly, and emotionally draining. That’s why we strongly encourage every client to make this part of their planning.
What Is A Health Care Proxy In Massachusetts?
Under Massachusetts General Laws Chapter 201D, every competent adult has the legal right to appoint another person to make health care decisions on their behalf if they become incapacitated. This legal document is called a Health Care Proxy. It names an “agent”—typically a spouse, adult child, friend, or trusted individual—who can speak with doctors, access medical records, and make decisions regarding treatment, medication, surgery, and end-of-life care when you are unable to do so.
The law is very specific: the agent’s authority takes effect only when your doctor determines in writing that you lack capacity to make or communicate health care decisions. Until then, you retain full control. That’s one of the biggest misconceptions we see—people worry that signing a health care proxy means giving up control. In reality, it simply ensures someone you trust can step in if needed.
Massachusetts law requires that the proxy be signed in the presence of two adult witnesses, neither of whom can be the named agent. These witnesses must affirm that you appeared to be of sound mind and free from coercion.
Why A Health Care Proxy Is Essential For Every Adult
Whether you’re a 22-year-old college student or an 80-year-old retiree, medical emergencies don’t discriminate by age. If you’re unconscious or unable to speak, and no proxy is in place, your medical team may be legally constrained in communicating with your loved ones. In some cases, family members may disagree about what care is appropriate. Having a health care proxy avoids these conflicts by giving one person clear legal authority to act.
It’s particularly important for unmarried couples and blended families. Under Massachusetts law, a partner who is not a legal spouse does not have default authority to make decisions unless designated in a proxy. If you want your partner—not a parent or sibling—to make decisions, the proxy is the only way to guarantee that outcome.
A health care proxy also allows you to express specific wishes about life-sustaining treatment, pain management, and spiritual considerations through a supplemental document often referred to as a “living will” or “advance directive.” While Massachusetts doesn’t have a statutory form for living wills, we can incorporate guidance directly into the proxy or draft a companion document to provide additional clarity to your agent.
Legal Ramifications Of Not Having A Proxy
If no proxy exists and you become incapacitated, your family may be forced to petition the Probate and Family Court for a guardianship under M.G.L. c. 190B, Article V. This is a public court process that can involve legal fees, delays, and potential disputes between family members. The court may appoint someone who doesn’t know your medical preferences or who doesn’t reflect your personal values. Worse, during the time the guardianship is pending, no one may have legal authority to make immediate decisions about your care.
Creating a valid proxy gives you peace of mind that your wishes will be respected and your loved ones won’t be left in the dark during a medical crisis.
Massachusetts Health Care Proxy Frequently Asked Questions
What Is The Difference Between A Health Care Proxy And A Durable Power Of Attorney?
A health care proxy authorizes someone to make medical decisions when you can’t. A durable power of attorney typically authorizes someone to handle financial and legal matters. They serve different but equally important roles in your estate plan.
Does My Health Care Proxy Need To Be Notarized In Massachusetts?
No. Massachusetts law does not require notarization. The proxy must be signed in the presence of two disinterested witnesses who attest that you appeared to be competent and free from coercion.
Can I Name More Than One Person In My Proxy?
You can name one primary agent and one alternate agent in case your primary is unavailable. However, Massachusetts law does not allow two co-agents to act simultaneously. It’s important to choose someone you trust and discuss your wishes with them ahead of time.
When Does The Health Care Proxy Go Into Effect?
Your agent’s authority begins only after your attending physician has determined, in writing, that you are incapable of making or communicating your own health care decisions. Until then, you make your own choices.
Can I Revoke Or Change My Proxy Later?
Yes. You can revoke or update your health care proxy at any time while you have the capacity. It’s a good idea to review your proxy every few years and update it after major life changes such as marriage, divorce, or death of your agent.
Do Hospitals And Doctors In Massachusetts Recognize Out-Of-State Proxies?
Generally, Massachusetts providers will honor out-of-state health care proxies if they appear valid. However, it’s best to have one prepared under Massachusetts law to avoid confusion or rejection during a crisis.
Should I Give Copies Of My Proxy To My Family And Doctor?
Yes. Your health care proxy should be shared with your primary care doctor, hospital, and the named agent. We also recommend keeping a copy in an accessible location and storing a digital version.
Is A Living Will Legally Binding In Massachusetts?
Massachusetts does not have a statute that gives legal effect to living wills. However, a living will can be a helpful guide for your agent when making difficult decisions and can be included as a supplemental directive.
What Happens If I Don’t Have A Health Care Proxy?
Without a proxy, no one has automatic legal authority to make decisions for you. This can delay treatment or force your loved ones into court to seek a guardianship. The court process can be stressful, expensive, and may not reflect your wishes.
Can My Spouse Automatically Make Decisions Without A Proxy?
Not necessarily. While medical professionals may consult with a spouse, they are not legally required to follow their decisions without proper documentation. Having a signed proxy avoids this uncertainty.
Call The Sullivan Firm P.C. For a Free Consultation
At The Sullivan Firm P.C., we work with individuals and families across Gloucester, Rockport, Manchester by the Sea, Beverly, and throughout Essex County to create legally sound, protective estate plans that include health care proxies. We believe everyone—regardless of age—should have a trusted agent designated to make medical decisions if the unthinkable happens.
Call The Sullivan Firm P.C. at 978-325-2721 for a free consultation. Our office in Gloucester, Massachusetts is ready to help you prepare this essential document so your wishes are honored and your loved ones are protected.