Medical power of attorney in Massachusetts: the health care proxy
The short answer
In Massachusetts, you name a health care agent in a health care proxy. You sign it in front of two adult witnesses, and no notary is needed. Your agent can't be a witness. Massachusetts has no law naming who decides if you never sign one, and no living will statute, so the proxy matters a great deal.
The question under every medical power of attorney is a simple one. If you can't speak for yourself, who talks to the doctor?
In Massachusetts, the answer depends almost entirely on whether you signed a "health care proxy." The person you name in it is your "health care agent." This page covers how to sign one, who can't witness, and what happens if you never do. It is part of our guides to estate planning by state. For the basics of the role, see what a medical power of attorney is.
How do I sign a health care proxy in Massachusetts?
Any competent adult may sign one. It must be in writing and signed by you, or by someone at your direction, in front of two adult witnesses (M.G.L. c. 201D, section 2).
The two witnesses sign too. They affirm in writing that you appeared to be at least 18, of sound mind, and under no constraint or undue influence. No notary is required.
The proxy must include a few things (M.G.L. c. 201D, section 4):
- Your name and your agent's name.
- A statement that you mean to give your agent authority over health care decisions.
- Any limits you want to place on that authority.
- A statement that your agent's authority starts when your attending physician determines, in writing, that you lack capacity.
The statute doesn't require any particular form. Any writing that includes these points and is signed correctly works. You may also name an alternate agent, a backup who steps in if your first choice can't (M.G.L. c. 201D, section 3).
Your financial power of attorney is a separate document with different rules. Our Massachusetts power of attorney guide covers it.
Who can't be my witness or my agent?
The rules are short.
| Person | Can be a witness? | Can be your agent? |
|---|---|---|
| The person you name as your health care agent | No | Yes |
| An operator, administrator or employee of a facility where you live, are a patient, or have applied | Yes | No, unless related to you by blood, marriage or adoption |
| A friend or neighbor over 18 | Yes | Yes |
| A relative over 18 | Yes | Yes |
The simplest path: ask two adult friends or neighbors who aren't your agent to witness (M.G.L. c. 201D, section 2, section 3).
What can my agent decide?
Your agent makes the health care decisions you would make. Your agent must follow your known wishes, including your religious and moral beliefs (M.G.L. c. 201D, section 5).
Your agent is a fiduciary: legally required to act in your interest and follow what you wrote. Day to day, that means talking with your doctors and agreeing to or declining treatment in light of your wishes.
Your agent's decisions come first. They take priority over anyone else's, including someone acting under your financial power of attorney.
Do I need a living will too?
Massachusetts has no living will statute. There is no separate state document with its own signing rules.
What you can do is write your wishes into the health care proxy itself. Chapter 201D lets you state limits and instructions inside the proxy, and your agent must follow them (M.G.L. c. 201D, section 5).
One more detail: if you never name an agent or give instructions, the law draws no conclusion about what you would have wanted (M.G.L. c. 201D, section 16). Our post on health care power of attorney vs living will explains how naming a person and writing down wishes work together, and treatment preferences helps you think through what to write.
Who decides if I haven't named anyone?
Massachusetts has no default medical decision-maker law. This is the most important fact on this page.
Most states have a law that lists which relatives can make medical decisions for you if you haven't named anyone, usually starting with a spouse, then adult children, then parents, then siblings. A handful of states have no general list, and Massachusetts is one of them.
Chapter 201D only says that, without a proxy, nothing in it stops a provider from relying on the informed consent of "responsible parties" for an incapacitated patient, "to the extent permitted by law" (M.G.L. c. 201D, section 16). It doesn't say who those people are or in what order.
| Your situation | Who decides under Massachusetts statute |
|---|---|
| You signed a health care proxy | Your health care agent, then your alternate |
| No proxy | The statute names nobody; providers may rely on "responsible parties" |
| A close friend who knows your wishes | No role in the statute unless you name them in a proxy |
A close friend has no statutory role. A friend may only start a court case over a dispute about an existing proxy (M.G.L. c. 201D, section 17).
Bills to create a priority list were pending in the 2025 to 2026 session but had not become law as of October 18, 2026 (H.4329, S.1047). Our post on medical decisions without a power of attorney compares other states, the 50-state guide to default decision-makers has the full picture, and our who decides for me page walks through the question.
The takeaway is simple. In Massachusetts, a signed proxy is the clearest way to make sure the right person is the one the doctor calls.
Here is a typical case, a composite. Ruth is 71, divorced, and lives in Newton. Her daughter lives in Oregon. Her friend Carol has driven her to every appointment for years. Ruth signs a health care proxy naming Carol, with her daughter as alternate.
How do I choose my agent?
The practical questions matter most. Is the person willing? Can they get to the hospital? Will they follow your wishes even when they'd choose differently?
- They know what you want, because you've told them.
- They can stay calm in a hospital hallway and ask questions.
- They live close enough, or can travel when needed.
- You've named an alternate in case they can't.
Our post on how to choose a medical power of attorney has more questions to ask.
Some people would like a professional standing by, first or behind a friend. A Kinly membership includes a medical power of attorney written for your state, and Trella Trust Company can be named in the role, first or as the backup to someone you choose.
When your health papers are done, our Massachusetts probate guide covers what happens to your home and savings later.
Common questions
Does a health care proxy need to be notarized in Massachusetts?
No. It must be signed in front of two adult witnesses, who sign too. No notary is required.
Who makes medical decisions in Massachusetts if there's no health care proxy?
Massachusetts law doesn't say. It has no default list of relatives. The statute only lets providers rely on "responsible parties" to the extent other law allows, which is why signing a proxy matters.
Can a close friend make medical decisions for me in Massachusetts?
Only if you name them as your health care agent in a proxy. Without that, a friend has no role under the statute.
Does Massachusetts have a living will?
No. Massachusetts has no living will statute. You can write your treatment wishes and limits into your health care proxy, and your agent must follow them.
Is there an official Massachusetts health care proxy form?
The statute doesn't require any particular form. Any written proxy that contains the required statements and is signed before two adult witnesses is valid.
Sources
- M.G.L. c. 201D, section 2: Health care proxy; execution (Massachusetts Legislature)
- M.G.L. c. 201D, section 3: Who may serve as agent (Massachusetts Legislature)
- M.G.L. c. 201D, section 4: Required contents (Massachusetts Legislature)
- M.G.L. c. 201D, section 5: Agent's authority (Massachusetts Legislature)
- M.G.L. c. 201D, section 16: When no proxy exists (Massachusetts Legislature)
- M.G.L. c. 201D, section 17: Court proceedings (Massachusetts Legislature)
- H.4329 bill page (Massachusetts Legislature)
- S.1047 bill page (Massachusetts Legislature)
This page is general information, not legal or financial advice. Laws vary by state.