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Part 1: In sickness and in health: healthcare vows


Healthcare Authorities: different from marriage vows

Everyone knows the traditional marriage vows and the portion “for better for worse, for richer for poorer, in sickness and in health,” the words to indicate to your partner that you will be there through thick and thin.

When people prepare their Estate Planning documents, they often name each other or a close family member without hesitating. However, Estate Planning documents related to healthcare are often triggered and used during non-life threatening situations. There are times when a partner becomes very sick or injured making them incapable of making their own decisions.  I had a friend who was put in a medically induced coma while he had pneumonia.  Though he was very sick and put on dialysis for a brief time, he did make a full recovery but during the time he was in a coma, his family members had to make decisions about his care.

Deciding who you appoint in as your Healthcare Authorities is not always just a natural selection of your partner or family members.  However, when you pick your “helpers” in your Estate Plan, you have to be very deliberate in your thought process and consider the strengths and weakness of the people you are considering. Often someone automatically chooses their spouse, the oldest adult child, a sibling or another first person who comes to mind. That may not be the right person.

Health Care Authorities Role and Duties

When you choose your Health Care Agent you have to remember what their role and duties will be. If you are sick or debilitated and cannot authorize your medical treatment, the Health Care Agent’s choices have a very important impact. The things you need to consider include the following:

  1. Will this person follow your desires as opposed to their own emotional desires?
  2. Do they have the tenacity to disagree with the hospital or healthcare provider and advocate a different health care solution for you?
  3. If you have specific religious beliefs about healthcare, are they aware and willing to follow through?
  4. Do they have the thoroughness to research other medical options and look at other treatments, other hospitals, or other care facilities?
  5. Do they have the “stick-to-itiveness” to push back against the Medical Provider or the Health Insurance Carrier, who may initially refuse a rehabilitation program or certain treatment, but may agree if thoughtful arguments are made and there is enough “push back” from your Healthcare Agent?

These are just a few of the common examples where your Healthcare Authority will need to make decisions.

Recently a friend told me that they changed their Healthcare Agent after looking at what had happened to a family member. The Healthcare Agent for the family member was a “big picture” person, seemed to have difficulty following details, seemed to have difficulty digging into the needed medical information, and did not push back against the healthcare that the family member was receiving.

The friend told me that if a second medical opinion had been obtained and a different course of treatment taken, they would have gotten a better health result.


When you are choosing your Health Care Agent, the one who will be making healthcare decisions for you if you are unable to do so, make sure that they have the right temperament for the position. That they will be able to dig into the details of the treatment. That they do have the tenacity to push back against the Healthcare Providers if a better option is available.  That they have the ability to dig in and to wrestle with the Medical Insurance Company as needed. In other words you may want to look for someone who has the ability to be thorough enough and tough enough to push back against a big and awkward health care system. Someone who has the “stick-to-itiveness” to keep going, even if the healthcare and rehabilitation or long term care situation lasts for years.

In our next blog we will look at certain requirements for those who serve as your Trustee (the person or entity who handles your money and financial affairs under your Trust, if you are unable to) or your Financial Power of Attorney. A different set of rules may apply.

At the Law Firm of Steven Andrew Jackson, Attorney and Counsellor at Law, we have helped hundreds of families protect themselves and their loved ones, avoid Estate Taxes and Probate Costs, and keep their Estate Plans current with the law through The Customized Protective Estate Planning Solution™.