A myeloproliferative neoplasm (MPN) diagnosis is a life-changing event that can alter the way you think about your future. Having cancer can put life into perspective and bring up issues that you may not have thought about, including how you want to be cared for if you cannot speak for yourself.

Many people struggle with advance care planning, such as creating a will or filling out advance directives. But planning for your future ensures that your wishes are fulfilled and gives your loved ones guidance in the face of challenging end-of-life care decisions. Familiarizing yourself with the process of designating a medical power of attorney agent will help you appoint the best person for this important function.

What Is Medical Power of Attorney?

A medical power of attorney, sometimes called a durable power of attorney for health care, is a legal document that gives another person the ability to make medical decisions on your behalf if you’re unable to make them yourself. In the U.S., specific laws vary from state to state for setting up a medical power of attorney. The person you choose may be referred to as your:

• Health care agent
• Health care proxy
• Health care surrogate
• Health care representative
• Health care attorney-in-fact
• Patient advocate

A medical power of attorney agent must follow any predetermined guidelines that you specify. However, they can make significant decisions, including whether to keep you on life support or discontinue medical treatment. Your agent may also decide if you will be an organ donor after death, but their authority otherwise ends once you’re no longer alive.

Potential Benefits and Risks

Although it can be difficult to think about, choosing a medical power of attorney agent can reduce the burden on your loved ones if your health declines. Outlining your preferences in advance directives gives you better control over your medical care. However, health care situations can be complicated, and having a trusted person who can act as your advocate will help your care team navigate unforeseen circumstances.

By making decisions in advance — or at least choosing someone who understands what you want — you can prevent others from grappling with difficult choices about your care or having regrets. Be sure to inform the person you choose as your agent so they can be prepared and available if called upon. It’s also a good idea to let your loved ones know your reasoning for choosing this person and encourage them to support your agent in fulfilling their decision-making responsibilities.

If you don’t choose a medical power of attorney agent, one may be chosen for you. The following people are legally authorized to make decisions about your health care (in the order listed) if you’re incapacitated:

• Any guardians or conservators previously appointed by a court
• A legal spouse or domestic partner
• An adult child
• An adult sibling
• A caregiver (who is not your health care provider)
• A close friend or nearby relative

If you don’t want any of the above to have power over your care, it’s important to put paperwork in place to specify that. Designating a medical power of attorney agent ensures that your preferred person or people will be in charge.

Of course, there’s always some risk involved when you give another person legal authority over your rights. However, medical power of attorney doesn’t come into play unless you don’t have the mental capacity or ability to communicate. A doctor must verify your inability to make health care decisions before your agent can intervene. You can also set limits on the types of medical decisions your agent can make for you, and they must follow any instructions you’ve provided. If a court believes that your health care agent is not acting in your best interests or in line with your previously designed desires, the right of medical power of attorney can be revoked.

Choosing the Right Person

The rules may vary by state, but in general, a person must meet a few criteria before they can be given medical power of attorney. For instance, your agent must be over 18 years of age (or legally emancipated). They can’t be your health care provider or your residential care provider (if you live in a facility). In addition, they should not be related to your health care or residential care provider.

Additionally, you’ll want to steer clear of choosing anyone you don’t fully trust or believe can handle the responsibility.

Examples of the people who are typically appointed to be health care agents include:

• A close friend
• A family member
• A member of your religious community
• A trusted neighbor

There’s a lot to consider before signing a medical power of attorney document, including whether you feel the other person is up to the task. Just because someone cares for you doesn’t mean they’re the best choice to act as your representative.

Ideally, you should choose a medical power of attorney agent before your health comes into question. Since circumstances may change over time, you have the right to change your agent or revoke their rights as long as you’re still capable of making your own health care decisions. If a spouse was given the power of attorney, they may have this right removed if a divorce occurs. Be sure to read through the terms or meet with a lawyer or social worker who can help explain the ins and outs of your medical power of attorney document before signing.

How Do You Complete the Process?

For most parts of the United States, there’s a simplified form you can use to designate your health care agent. This bare-bones multistate form is valid in every state except Ohio, New Hampshire, Texas, and Wisconsin. Each of these states has its own mandatory disclosure statement.

You should be able to find medical power of attorney forms on your state government’s website. Most states don’t require a notary, but typically two witnesses must be present to certify that you signed the forms. Different states have specific rules on who can serve as a witness, so be sure to read the terms carefully or seek legal counsel to help you.

While selecting a medical power of attorney agent, you may also want to put other legal documents in place that define the type of medical treatment you want, how your bank accounts will be managed, and who will care for your children (if applicable). Ask your MPN specialist for a referral to a social worker or lawyer who can help you with the process while you’re still in a sound state of mind. Taking these steps isn’t just important for people with cancer, but for any adult who wants a say in their future care.

Talk With Others Who Understand

On myMPNteam, the social network for people with MPNs, you can connect with other people living with MPNs. Members come together to ask questions, give advice, and share their stories with others who understand life with MPNs.

Have you designated a medical power of attorney? How did you choose the right person, and what was the process like? Share your insight in the comments below, or start a conversation by posting on myMPNteam.