Young Adults Turning 18

When a child approaches his/her 18th birthday and has the ability to decide, it is recommended the young adult choose a health care agent and complete a health care proxy.

Key Life Milestones

An initial conversation about values and life goals should occur at some key times that indicate a young adult is maturing—such as obtaining a driver’s license, turning 18, leaving home to go to school, work or into the military, or marriage.  These are major milestones in life when risks and responsibilities for actions may change.

Act When You’re Young and Healthy

Appointing a health care agent is a good idea for everyone 18 years of age and older. A health care agent can act on your behalf if you become even temporarily unable to make your own medical decisions due to acute illness or injury. This situation might occur if you are under general anesthesia or are in a become coma because of an accident.

When you are able to make your own medical decisions again, your health care agent will no longer be authorized to act and make medical decisions on your behalf.

Why a Health Care Agent is Needed

There are two situations in which a health care agent will be needed:

• Temporary inability to make health care decisions – no matter what your age is. For example, you are having an outpatient surgical procedure and are under general anesthesia. Something unexpected happens and a medical decision needs to be made. If you have a health care agent, since you are temporarily unable to make your own decisions, the health care agent may make the medical decision. Once you become conscious again and have the ability to make medical decisions, the health care agent would no longer have any authority to act.
• Permanent inability to make health care decisions – this would arise if you were comatose from a terminal illness, in a persistent vegetative state, or suffered from an illness that left you unable to communicate. Under these circumstances you would obviously be unable to make your own medical decisions. If you have appointed a health care agent, your health care agent can be your voice and make your medical decisions according to your own wishes, or your best interests. If you don’t have a health care agent, a surrogate authorized under Family Health Care Decisions Act <<link to FHCDA under Ethics, Laws & Regulations/Advance Care Planning>> would have the authority to make medical decisions. You do not have control of who would be making medical decisions on your behalf.

Serious Illness in Childhood

A parent or guardian makes medical decisions for a seriously ill child, including medical decisions regarding life-sustaining treatment on the MOLST. When a child has the ability to make decisions, the child may participate jointly with the parent or guardian.

When a seriously ill young adult chooses a health care agent at the age of 18, the health care agent makes medical decisions if the young adult loses the ability to make medical decisions. If the seriously ill young adult doesn’t have a health care agent, a surrogate authorized under Family Health Care Decisions Act would have the authority to make medical decisions.

Younger than age 18

Adolescents, over the age of 16 and younger than age 18, who are married, have a child of their own or are living independently may be considered “emancipated.”  In this situation, the adolescent can choose a health care agent and complete a health care proxy form.