Making Health Care Decisions

The time may come when we are unable to make our own health care decisions. We may be too ill too speak, or too confused. We may become unconscious. In those situations, whether permanent or temporary, we have lost our decision-making capacity. Another person will have to make health care decisions for us.

Who Determines that You Can No Longer Make Decisions?

Your doctor is the only person who can determine whether you have lost the capacity to make health care decisions. Another person can begin making health care decisions for you only after your doctor has made the determination you no longer have decision-making capacity. Learn more about making health care decisions from New York State Department of Health.

Appoint a Health Care Proxy in Advance

This is the best way to make certain you receive the medical care and treatment you want when you can no longer speak for yourself. You name someone you trust to make health care decisions for you. This person is called a health care proxy. To appoint a health care proxy, you should plan ahead while you still have the ability to make your own decisions. You can do this by completing a health care proxy form while you are at Roswell Park. A health care proxy is a type of advance directive. An advance directive refers to any written instructions about health care treatment made by adult patients before they lose decision-making capacity. A health care proxy only takes effect if you lose the ability to make your own decisions.

Appointing a health care proxy and completing advance directives are the best ways to take control over your illness. Both of these acts let your doctors and caregivers know what care you wish to receive rather than someone you haven’t chosen making these decisions for you. We encourage you and any of your family members over 18 years of age to complete a health care proxy form and have it included in your medical records at Roswell Park. We can provide you with copies for any other doctors that you go to and for your health care agents. It is your responsibility to make others aware that you have put your wishes in writing. If your wishes change, you can always create a new document. Social Workers are available to assist patients and their families in completing the documents.

Contact the Social Work office at 716-845-8022 for forms and assistance. We are all here to make sure your wishes are identified and followed. You can also find the forms at the New York State Health Department Web site.

If You Haven’t Named a Health Care Proxy, a Surrogate Will Make Decisions for You

Appointing your health care agent is the best way to make sure your wishes are followed regarding your care and treatment if you have lost the ability to make your own decisions. However, if you have not completed a health care proxy form to name your health care agent, New York State law specifies who will make those decisions for you. According to New York’s Family Health Care Decisions Act, patients in this situation will have their medical decisions made by family members or a close friend. These decision-makers are called surrogates.

Who Can be a Surrogate?

The law provides a surrogate list that names the people who may make health care decisions for you. Here is the surrogate list in priority order, with the highest priority at the top:

  • your spouse, if not legally separated from you, or your domestic partner;
  • a son or daughter, 18 or older;
  • a parent;
  • a brother or sister, 18 or older;
  • a close friend

How is a Surrogate Chosen From the List?

The person with the highest priority will be the first one asked to make your health care decisions. Given the list above, the highest priority would be your spouse or domestic partner. If that person is not available, or if you do not have a spouse or domestic partner, the next available surrogate will become your decision-maker.

Who is Considered a Domestic Partner?

A domestic partner is a person who lives with you, depends on you for support, shares the ownership of a house, income, or expenses, is raising children with you, and/or plans on getting married to you. A domestic partner is recognized as your partner by a government agency or an employer and/or is covered under your employment benefits or health insurance. Certain people cannot be considered domestic partners. This includes anyone under the age of 18 as well as extended family members of you or your spouse.

Who is Considered a Close Friend?

A close friend is anyone, 18 years or older who has been in regular contact with you, and who is familiar with your activities, health, and religious or moral beliefs. To be a surrogate, your friend must present a signed statement that explains how he or she fulfills these criteria.