New York State Health Care Proxy
- What it does: Lets you name a health care agent who will make decisions if you cannot make them yourself.
- When it takes effect: Only after two doctors decide you are not able to make your own decisions.
- Standard New York State form? Yes. (See Additional Resources) Give copies to your health care agent, your close family members, your doctors and others involved in your care.
- What it does: Lets you say what care you want —or don’t want—at the end of life.
- When it takes effect: When you cannot make your own decisions, and your doctor confirms that you have an incurable condition.
- Standard New York State form? No. Sample forms are available. (See Additional Resources) You can also write special instructions on your Health Care Proxy form.
Do Not Resuscitate (DNR) Order
- What it does: Tells health care providers and emergency workers not to revive you if you stop breathing or your heart stops beating.
- When it takes effect: When signed by your doctor.
- Standard New York State form? Yes.
- Hospitals have their own forms.
- Anyone not in a hospital can use a “Nonhospital Order Not to Resuscitate.” (See Additional Resources) Keep the form where everyone can see it.
- If you are too sick to agree to a DNR, your health care agent or your closest family member can agree.
- You can also write DNR instructions on your Health Care Proxy form or Living Will.
Advance Directives Are Not Just for the Elderly
There are times when people—even young, healthy people—can't make their own decisions about medical care.
- You could be injured in an accident and arrive at the hospital unconscious.
- You might be under general anesthesia for routine surgery when something unexpected happens.
- You could an illness that leaves you unable to speak, or you are comatose.
Who Will Speak for You?
- Friends or family members can always tell health care providers what they think you would want. But in New York State, they cannot direct your medical care unless you appoint them in writing.
- No one—not even your spouse—can act on your behalf unless you appoint them using the New York Health Care Proxy form. "Proxy" means "substitute" - a person who can act as your agent.
- The New York Health Care Proxy form is an advance directive that lets you express your wishes in advance.
- You can say what care you do—or do NOT—want. Your health care proxy (your agent) must follow your directions.
Gain More Control Over Your Care.
- Everyone 18 and older should have a health care agent.
- When you appoint an agent, you help your family avoid confusion and conflict. There is no doubt about who will make decisions.
- When you appoint an agent, you claim your legal right to ask for—or refuse—medical care.
- Hospitals, nursing homes, doctors and other health care providers must follow your agent's decisions as if they were your own.
How to Appoint a Health Care Agent
It's easier than many people think.
- Select an adult you trust, such as a family member or a friend, as your agent on the New York State Health Care Proxy form. You can also name an alternate agent who will take over if your primary agent is not available.
- Discuss your wishes with your health care agent. Talk about your values and beliefs.
- No one can plan for every scenario. The more your agent knows, the easier it will be for that person to make decisions for you.
- If you wish, you can use the New York State Health Care Proxy form to write specific directions about the kind of care you want or don't want, just as you would in a Living Will or a Do Not Resuscitate (DNR) Order.
- If you like, you can simply write, "my agent knows my wishes."
- You can also use the New York State Health Care Proxy form to give instructions about organ donation, if you wish.
- You do not need a lawyer or a notary to sign the form - just two adult witnesses.
- You can change your New York State Health Care Proxy form or appoint a new health care agent when ever you want. Simply fill out a new form.
Hospice: Care and Comfort at the End of Life
- Hospice is a service for people with terminal illness who are expected to live 6 months or less.
- Hospice care is is designed to meet the physical. mental, spiritual, social and economic needs of patients and their families during the final stages of illness, dying and bereavement.
- Hospice care is given in hospitals, nursing homes, assisted-living facilities or at home.
- You or your health care agent can choose a hospice program in advance to meet your needs.
- Medicare, Medicaid and other health insurance plans often cover hospice care.
Forms & Publications
Last Updated: March 16, 2012