COMPLETING A HEALTH CARE PROXY
Massachusetts law allows you to use any form for a proxy, and you do not necessarily
need to involve an attorney, as long as the form complies with the following basic
requirements.
The proxy must identify you as the principle and the person you select as your health
care agent.
The proxy must state that you intend to authorize your agent to make health care
decisions on your behalf, and indicate that this authority will become effective when a
doctor determines that you lack the capacity to make health care decisions.
Your proxy must be signed and dated in the presence of two witnesses who must
also sign the document. Your appointed agent may not sign as a witness.
The proxy included at the end of this Guide satisfies the basic requirements of
Massachusetts law and conforms with Catholic teaching. It provides space for you to
write down specific limitations that you may want to place on your agent's
decision-making authority, as well as any personal wished, moral values, and religious
beliefs that you may want the agent to take into particular account.
Make and distribute copies of your proxy to your doctor, health care agent, family
members, close friends, pastor, or anyone else who should aware of your wishes. Be
sure to include on the back of any copies the seven guiding Catholic principles.
More importantly, discuss your wishes with your doctor, agent, family, and trusted
friends.
MASSACHUSETTS CATHOLIC CONFERENCE
West End Place
150 Staniford Street
First Floor
Boston, Massachusetts 02114-2511
Phone: 617-367-6060
Fax: 617-367-2767
Website: www.macathconf.org