How to choose a medical power of attorney: 9 questions to ask
The short answer
Your medical power of attorney should be someone who says yes and means it, stays steady under stress, will follow your wishes even when they'd choose differently, and can be reached quickly. Check that your state allows them to serve, talk through your wishes before you sign, and name a backup.
Who should be my medical power of attorney? It's the question people circle longest.
The documents themselves are quick. Choosing the person who'll sit with your doctors, if you can't, takes more thought.
It helps to stop asking "who loves me most" and ask "who can do this job." This page gives you nine questions for each candidate, then what to discuss before you sign. It's part of our guide to the four roles in an estate plan.
What the job actually involves
Your health care agent talks with doctors, reads your chart, and agrees to or declines treatment when you can't decide. In Washington, an agent with general health care authority can give informed consent for you and see your health information, under RCW 11.125.400.
It's a different job from the others in your plan.
An executor or a trustee does paperwork over months. A medical agent may have to decide in an afternoon, in a hospital corridor. (Our page on executor vs trustee explains those two.) Our page on what a medical power of attorney is covers the role in full.
The 9 questions
1. Will they say yes, and mean it?
Ask them directly. A name in a document doesn't oblige anyone to serve.
The Washington State Medical Association (WSMA) offers guidance here. A good agent, it says, understands the role and is willing to fill it. A pause or a "well, if I have to" is worth listening to.
2. Can they stay steady when things are hard?
Medical decisions come at stressful moments. WSMA also says your agent should be able to make decisions in difficult or stressful times.
Think of how this person handled a past crisis. Did they freeze, panic, or get practical?
3. Will they follow your wishes, even if they'd choose differently?
This may be the most important question. Washington's law tells anyone deciding for you to first decide in good faith whether you would agree to the proposed care. Only if they can't tell do they decide on your best interests, under RCW 7.70.065.
So you want someone who can set aside their own views. Someone who'd say, "I wouldn't choose this for myself, but it's what she wanted."
4. Can they be reached, and get there?
Much of the work happens by phone now, but some of it happens at the bedside. Think about distance, work hours and time zones.
Being unreachable has a real cost. Washington's consent list has an order (RCW 7.70.065). If a provider makes reasonable efforts and can't find anyone in a higher class, they move to the next. An agent who can't be found may be passed over for the next person on the default list.
5. Will they speak up with doctors?
A good agent asks questions, asks for things in plain words, and asks for a second opinion if something doesn't sit right. They don't need medical training. They need to be comfortable saying, "Please explain that again."
6. Are they legally allowed to serve?
Most adults can serve, but rules vary by state. In Washington, these people can't be your agent unless they're your spouse, registered domestic partner, parent, adult child or sibling (RCW 11.125.400):
- your physicians and their employees
- owners, administrators or employees of a health care or long-term care facility where you live or receive care
That second point matters if you might move into assisted living. A friend who works there may no longer qualify.
7. How will your family respond?
In Washington, the agent you name ranks above your spouse, adult children and other relatives on the medical consent list (RCW 7.70.065). That's the point of naming someone. It also means your agent may need to hold firm if relatives disagree.
Choose someone who can stay kind and stay steady at the same time. Telling your family your choice now, and why, makes that easier.
8. Will they still be able to do this in ten or twenty years?
You're choosing for a future you can't see. A friend your own age is a wonderful choice today. Picture them at 85, too.
A spouse may face the same emergency you do. In Washington, a spouse's authority as agent also ends when a divorce or legal separation is filed, unless the document says otherwise, under RCW 11.125.100.
9. Who is the backup?
Washington lets you name successor agents who step in if your first choice resigns, dies, becomes incapacitated, isn't qualified or declines, under RCW 11.125.110. Choose a backup who doesn't share your first choice's weak spot, such as age or distance.
You can also name co-agents, but in Washington they must act together unless the document says otherwise (RCW 11.125.110). For fast medical decisions, one agent with a backup is usually simpler. Our page on naming a backup in every role covers how to set the order.
A quick scorecard
Score each person you're considering. You won't find someone perfect on every line; look for the person who's strong where it counts most for you.
| Question | Candidate A | Candidate B |
|---|---|---|
| Said yes, and meant it | ||
| Steady under stress | ||
| Will follow my wishes over their own | ||
| Reachable and close enough | ||
| Comfortable speaking up | ||
| Legally allowed to serve | ||
| Can hold firm with family | ||
| Likely available for years | ||
| Good fit as first, or as backup |
What to talk about before you sign
Once you've chosen, sit down together. WSMA's guidance stresses preparing your agent by sharing your completed documents, and helping them describe to your care team what "living well" means to you.
Cover these, in your own words:
- what a good day looks like for you, and what you'd find hard to live with
- your feelings about life support, feeding tubes and resuscitation
- where you'd want to be cared for, if you had a choice
- who else you'd like kept informed
- the small things: your dog's routine, the plants, the neighbor with the key
Write your wishes down too. A living will records them in your own words. Our page on health care power of attorney vs living will explains why the two work best together. Then give copies to your agent, your backup and your doctor.
A typical case
Here is a typical case, a composite. Patricia is 67, never married, with a brother in Arizona and a close friend, Ellen, who lives two streets away.
Her brother is devoted but would need a flight to reach her. Ellen is calm, asks good questions and once sat with Patricia through a scary diagnosis. Patricia names Ellen first and her brother as backup, and they all have dinner to talk through her wishes.
If the right person isn't obvious
That's common, and it isn't a gap in your life. Some people name a friend; the page on naming a friend as power of attorney covers that choice. Others name a professional, first or behind someone they love.
A professional agent is also a fiduciary: legally required to act in your interest and follow what you wrote. Kinly's membership includes a medical power of attorney written for your state, and Trella Trust Company can be named first or as backup. The guide to choosing professional help compares the options.
Common questions
Should my medical power of attorney be my oldest child?
Not necessarily. Birth order isn't a qualification. Choose the child, or other person, who is willing, reachable, steady under stress and ready to follow your wishes.
Can I name two people as my medical power of attorney?
You can name co-agents, but in Washington they must act together unless the document says otherwise. That can slow urgent decisions. Many people name one agent and a backup instead.
Can my medical power of attorney live in another state?
Yes. Much of the work can happen by phone, but some decisions are easier in person. If your first choice is far away, consider someone nearby first and them as backup, or the other way round.
What if my medical power of attorney disagrees with my family?
In Washington, the agent you named ranks above your spouse and children on the medical consent list. Your agent's job is to follow your wishes. Telling your family your choice now helps prevent conflict later.
Can a friend be my medical power of attorney?
Yes. In Washington, a friend can serve unless they're your physician or work for one. Staff at a facility where you live or receive care are also barred. Without a document, a friend comes last on the default list.
Sources
This page is general information, not legal or financial advice. Laws vary by state.