What is a medical power of attorney?

Updated 2026-10-16 · Expert review in progress

The short answer

A medical power of attorney is a legal document that names someone, your health care agent, to make medical decisions for you when you can't make them yourself. Your agent talks with doctors, sees your records and consents to or refuses treatment. They are guided by what you would want.

What is a medical power of attorney? It is the document that answers one question: if you can't speak for yourself, who talks to the doctor?

The person you name is your health care agent. They might be a sister, a close friend, an adult child or a professional. This post explains what they decide, when they start, and the limits on the role. It is part of our guide to the four roles in an estate plan, where the medical power of attorney comes first.

What does a medical power of attorney decide for me?

Your agent makes the health care decisions you would make if you could. The exact scope depends on your state and on what your document says. Here is Washington, as a worked example.

In Washington, an agent with general health care authority can provide informed consent for health care decisions on your behalf. They can also act as your representative under HIPAA, the federal health privacy law, which lets them see your medical information (RCW 11.125.400).

In everyday terms, that usually means decisions like these:

Agreeing to, or declining, a test, surgery or new medicine.
Talking with your doctors and nurses, and asking the questions you would ask.
Reading your chart and test results.
Weighing life-sustaining treatment, such as a ventilator or a feeding tube, in light of your wishes.
Choosing comfort care when that is what you'd want.

Your document can widen or narrow those powers. Many people add written wishes so their agent isn't guessing. That is what a living will does. Our post on health care power of attorney vs living will explains why you probably want both.

How does my agent know what I'd want?

The law tells them how to decide. In Washington, anyone consenting for you must first decide in good faith whether you would agree to the proposed care. Only if they can't tell do they decide based on your best interests (RCW 7.70.065).

Washington's power of attorney law says the same in other words. An agent must act according to your reasonable expectations, as far as they know them, and otherwise in your best interest (RCW 11.125.140).

That makes your agent a fiduciary: legally required to act in your interest and follow what you wrote. The more you tell them now, the less they have to guess later.

When does a medical power of attorney start?

There are two parts to the answer: when the document takes effect, and when your agent actually decides.

In Washington, a power of attorney takes effect when signed, unless it names a future date or event (RCW 11.125.090). Some people choose a "springing" document that starts on incapacity. Our post on springing vs immediate power of attorney covers the trade-offs.

Even when it is in effect, you stay in charge while you can decide. Washington presumes an adult has capacity. A provider must document why they've concluded you can't make a particular decision before someone else consents for you (RCW 7.70.065).

So your agent steps in only for the decisions you can't make. If you recover, the decisions come back to you.

Who can be my medical power of attorney?

Most adults you trust can serve. But some people are barred, and the rules vary by state.

In Washington, these people can't be your health care agent (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.

The one exception is a close relative: a spouse, registered domestic partner, parent, adult child or sibling.

Beyond the legal rules, the practical questions matter more. Is the person willing? Can they get to the hospital? Will they follow your wishes even if they'd choose differently? Our post on how to choose a medical power of attorney has nine questions to ask.

If your first choice is...	Worth thinking about
A spouse or partner	Name a backup; you may face the same emergency together
A child far away	Someone nearer as first, with your child as backup
A friend your age	A younger backup, or a professional behind them
Several children	One agent rather than co-agents, so decisions don't stall

What a medical power of attorney can't do

The role has limits, and they protect you.

It ends at death. In Washington, a power of attorney terminates when you die (RCW 11.125.100). After that, your executor handles the estate.
A spouse's authority ends with a divorce filing. In Washington, a spouse's authority as agent ends when a divorce or legal separation is filed, unless the document says otherwise (RCW 11.125.100).
It doesn't cover money. Paying bills needs a financial power of attorney. Washington does require a financial agent to cooperate with your health care decision-maker (RCW 11.125.140).
Some choices stay yours. Rights under Washington's Death with Dignity Act can't be exercised by anyone on your behalf (RCW 7.70.065).
Guardian-level limits apply. Washington gives a health care agent the same limits as a court-appointed guardian. Choices you made in a mental health advance directive are an exception (RCW 11.125.400).

How do I make one in Washington?

A Washington power of attorney covers health care decisions only if it expressly grants that authority (RCW 11.125.240). So the words matter.

It must be signed and dated. Then it is either notarized or signed before two witnesses (RCW 11.125.050). The witnesses can't be related to you or your agent, and can't be your home care provider or a care provider where you live.

Then share it. Give copies to your agent, your backup and your doctor. Our post on what an advance directive is includes a checklist of wishes to write down alongside it.

What happens if I don't have one?

State law picks for you. In Washington, the list starts with a court-appointed guardian, then the agent you named, then a spouse or registered domestic partner. Next come adult children, parents, adult siblings and more distant relatives (RCW 7.70.065).

A close friend comes at the very end, and only with a sworn declaration. Naming an agent moves the person you actually trust near the top. Our post on medical decisions without a power of attorney walks through the default list.

Here is a typical case, a composite. Joan is 71, divorced, and her daughter lives in Denver. She names her neighbor Diane, who has the spare key and walks Joan's dog, as her health care agent. Her daughter is the backup.

When Joan has emergency surgery, Diane is at the hospital within the hour. She calls Joan's daughter after each conversation with the surgeon.

Some people would like a professional standing by, first or behind a friend. Kinly's membership includes a medical power of attorney written for your state, and Trella Trust Company can be named in the role. You can read how it works.

Common questions

What is the difference between a medical power of attorney and a health care proxy?

Usually nothing. "Health care proxy," "health care agent" and "medical power of attorney" are different names for the same idea in different states. Each names a person to make medical decisions when you can't. Washington's statutes call it a durable power of attorney for health care.

Can my medical power of attorney override my wishes?

Your agent's job is to carry out your wishes, not replace them. In Washington, anyone consenting for you must first decide in good faith what you would want. And while you can still decide for yourself, the decisions stay with you.

Does a medical power of attorney need to be notarized?

In Washington, it must be either notarized or signed before two qualified witnesses. The witnesses can't be related to you or your agent, or be your care providers. Other states have their own rules.

Can my doctor be my medical power of attorney?

Not in Washington, unless they are a close relative. State law bars your physicians and their employees. It also bars staff at a facility where you live or receive care.

Does a medical power of attorney end when I die?

Yes. In Washington, a power of attorney terminates at death. After that, your executor settles your estate, and your successor trustee handles anything held in a trust.

Sources

This page is general information, not legal or financial advice. Laws vary by state.

Keep reading

The four rolesHealth care power of attorney vs living will: you probably need bothA health care power of attorney names someone to decide for you. A living will records your wishes. How they differ, and why most people need both.The four rolesHow to choose a medical power of attorney: 9 questions to askWho should be my medical power of attorney? Nine questions to ask about anyone you're considering, plus what to talk about before you sign the document.The four rolesThe four roles in an estate plan, and who should fill themWho should I name as power of attorney, executor and trustee? A plain guide to the four roles in every estate plan and how to choose who fills each.The next-of-kin gapWho decides for you when you can't? The next-of-kin gapWho is my next of kin, and who decides for me if I can't? How the law picks medical decision makers, heirs and executors, and how to close the gap.