What is a health care proxy form?
The New York Health Care Proxy Form
is a type of advance directive.An advance directive is a document where you describe your wishes for your medical treatment in the event that you are unable to describe it yourself. The Health Care Proxy Form allows you to document your preferences for medical treatment, and allows you to appoint a trusted person to become your Healthcare Agent. Your Health Care Agent is someone whom you would want to communicate your wishes for medical treatment if you become unable to communicate. The agent can be whomever you wish, such as a friend or family member. Designating your health care agent on the Proxy Form gives the person you choose the ability to communicate your medical wishes for you.
What else should I know about the health care proxy form?
The form does not need to be completed with the assistance of a lawyer, and does not need to be notarized. Instead, the form must be signed by two witnesses 18 years of age or older who can confirm that you are the one who completed the form. No one listed as a health care agent can sign the form. Since social distancing makes it difficult to have people physically sign the form, Governor Cuomo granted permission under executive order
to allow electronic signatures by video conference call.
What should my health care agent know?
Your health care agent should know what is important to you and what your values are, and they should also have a copy of the health care proxy form. For example, your health care agent should know whether you would want everything possible done to keep you alive or whether you would prefer not to have certain interventions. The agent should know what types of things you would or would not want, so they can make the same decisions you would have made if you could communicate them.
How does the coronavirus (COVID-19) impact the need for a proxy form?
Everyone 18 year of age or older should have a completed health care proxy form in case something unexpected happens. Despite the importance of completing an advance directive, many people have not completed these forms. Unfortunately, communities of color are even less likely to have completed advance directives, but are disproportionately impacted by COVID-19.
COVID-19 is dramatically impacting the health and well-being of New Yorkers, and has created a more urgent need to engage in informed, educated advance care planning. It is important that the form be completed before a person becomes sick, and by the time a person is hospitalized with COVID-19 they may be too sick to communicate their wishes. Without documentation of their wishes, both family members and doctors may not know what type of treatment they would want. If a COVID-19 patient has advance directives, there is a greater likelihood that their wishes will be known and honored-sparing doctors and loved ones uncertain, difficult medical decisions (e.g., use of a ventilator and other interventions and if/when these may be withdrawn).
How does a health care proxy form differ from a living will?
There is no official New York State form for a living will, but the health care proxy form is an official form issued by New York State. A living will lists the types of health care treatments you would or would not want under various circumstances, but a health care proxy form is still needed to give permission for a specific person to serve as your health care agent. Since you can describe your wishes on the health care proxy form, a living will is optional, but may be helpful if you have specific wishes you would like to
detail. A living will is often written in consultation with a lawyer, but this is not required.
What if I have questions about the form?
If you have any questions about the form, please schedule a virtual appointment on the Health Care Proxy Helpline at a time convenient to your schedule.
This Helpline is a free service run by End of Life Choices New York and the Completed Life Initiative. The Helpline provides one-on-one sessions with trained bioethics practitioners, our Advance Directive Advocates, who are available to answer your questions and witness your Proxy form being completed. You will have the opportunity to speak via phone or videoconference (Google meet
) with a trained Advance Directive Advocate—all for free!
What happens during my free virtual appointment with an Advance Directive Advocate?
You’ll have the chance to speak with one of our Advance Directive Advocates via phone call or Zoom, who will guide you through the form, answer any questions you have, and may serve as witnesses (via Zoom) to sign the form.
Please note that our Advance Directive Advocates cannot offer legal or medical advice, serve as your healthcare agent, or tell you what to write on your Proxy form. They also cannot serve as your Health Care Agent. Only someone whom you know, whether a trusted friend or family member, may become your Health Care Agent. Once you schedule your appointment, you can select a 30 minute counseling call, a 15 minute
witnessing call (if you have already completed a health care proxy form and just need it witnessed), or a 45 minute call that includes both services.
What should I do before my virtual appointment?
Prior to your appointment, click here to read through the New York Health Care Proxy Form. The first few pages are frequently asked questions.
If you have scheduled a Signature witnessing appointment (15-minute appointment if you have already filled out a health care proxy form and just need it reviewed, signed, and witnessed) or Combined appointment (45-minute appointment where our advocates will go over the health care proxy form and help you sign your advance directive with witnesses). - you will be asked to show a photo ID (passport, driver’s license) during the video call. We will never ask about immigration status.
If you have time, please review these other resources:
Planning for a Better End of Life - A 25-minute video that discusses: health care proxies, living wills, and other advance directives (with a focus on NY); palliative care and how/when it can benefit you; how hospice care can improve quality of life; and telling your doctors about your end of life care wishes.
The Conversation Project - They have helpful resources on how to select a health care agent.
Liveon New York - A nonprofit organization that works to educate New Yorkers about organ and tissue donation.
End of Life Choices Resources on other directives