One major misconception is that married couples can make medical decisions for each other without documentation in place. Without a health care power of attorney, no one can make medical decisions for you, except a legal guardian.
Becoming a legal guardian for your spouse or loved one requires a request (a petition) to the probate court for the appointment. A court hearing is required. There are filing fees, guardian ad litem fees; and unless there is truly a life and death decision to be made, the appointment will not happen for approximately a month after the petition is filed. Furthermore, the request is made in public court. In court, you must prove to the judge that a guardianship is needed and explain why you are the best person for the appointment. Too often, adult children struggle and even litigate over the position to be appointed as guardian. Ultimately, the judge decides who is appointed as the guardian as well as the breadth of the powers given to the guardian.
All of the cost, stress, delay, inconvenience and loss of control can be easily avoided by taking a little time to plan. When preparing a health care power of attorney, careful thought must be given in deciding the appointment of primary, secondary and alternate agents. Trustworthiness, geographic proximity, integrity and willingness to serve are all factors to consider. Additionally, there are specific requirements of a patient advocate designation and the persons permitted to witness the execution of the document cannot include close family members or care providers.