What a healthcare agent is
A healthcare agent (also called a healthcare proxy or patient advocate) is the person you authorize to make medical decisions for you when you cannot make them yourself. This authority comes from a Healthcare Power of Attorney, one of the five core estate planning documents.
In Illinois, the Healthcare Power of Attorney is governed by the Illinois Power of Attorney Act (755 ILCS 45/4-1 et seq.). Your agent's authority begins when your attending physician certifies that you lack decision-making capacity.
What powers your agent holds
Your healthcare agent can do anything you could do yourself with respect to your medical care, unless you explicitly limit those powers in your document. That includes:
- Consenting to or refusing any medical treatment, procedure, or medication
- Accessing your medical records (with or without a separate HIPAA authorization)
- Choosing or changing your treating physicians and facilities
- Making decisions about life-sustaining treatment, including whether to withdraw it
- Making decisions about anatomical gifts and autopsy
- Arranging for your discharge or transfer between facilities
Qualities to look for
Your healthcare agent doesn't need to be a doctor, lawyer, or even a family member. What they need is:
- Availability, can they be reached quickly in an emergency, day or night?
- Proximity, are they close enough to get to a hospital when needed?
- Emotional steadiness, can they make difficult decisions under pressure, even if family members disagree?
- Knowledge of your values, not just your medical wishes, but what quality of life means to you
- Willingness to advocate, will they push back on medical providers when necessary?
The conversation you must have
Naming someone as your healthcare agent without telling them, or without having a real conversation about your wishes, puts them in an impossible position. They may not know whether you'd want aggressive intervention or comfort care in a given situation.
The conversation doesn't have to be a single formal event. It can happen over time. But at minimum, your agent should know: your general values about quality of life vs. length of life, your feelings about life-sustaining treatment (including ventilators, feeding tubes, and resuscitation), your preferences about pain management, and where you would want to die if you had the choice.
Your healthcare agent can only advocate for what they know you want. The document authorizes them to act; your conversations guide how they act.
Name a successor agent
Your primary agent may be unavailable, incapacitated, or unwilling to serve when needed. Always name at least one successor agent. Some documents allow for two successors, who would serve in order.
Illinois-specific rules
In Illinois, your healthcare agent cannot be your treating healthcare provider or an employee of your healthcare facility (with limited exceptions). Two witnesses must sign your Healthcare Power of Attorney, and neither witness can be your named agent, a relative who would inherit from you, or anyone who will pay for your care.