A healthcare power of attorney is a legal document that allows you to designate a trusted person—your healthcare agent—to make medical decisions on your behalf when you are unable to make or communicate those decisions yourself. In Illinois, this document is governed by the Illinois Health Care Surrogate Act (755 ILCS 40/) and the Illinois Power of Attorney Act (755 ILCS 45/), and it is considered one of the most essential components of any comprehensive estate plan. Without a healthcare power of attorney, decisions about your medical treatment during a crisis may be made by someone you would not have chosen, following a statutory priority list that may not reflect your wishes or family dynamics.
What Is a Healthcare Power of Attorney?
A healthcare power of attorney (also called a healthcare proxy or medical power of attorney) is a written directive in which you (the principal) name another person (your agent) to make healthcare decisions for you when you cannot make or communicate them yourself. Unlike a living will, which provides specific instructions limited to end-of-life situations, a healthcare power of attorney grants broad decision-making authority across all medical situations where you are unable to participate—from emergency surgeries and treatment plans to rehabilitation choices, medication decisions, and care facility selection.
Your healthcare agent does not make decisions for you while you are competent and able to communicate. The authority activates only when your attending physician determines that you lack the capacity to make your own healthcare decisions. As long as you can understand the relevant information and communicate your choices, you remain in control of your own medical care. The healthcare power of attorney serves as a safety net for situations where you cannot advocate for yourself.
Any person who is not a minor and who has the capacity to make health care decisions may designate a health care agent by executing a health care power of attorney. The agent may make health care decisions on behalf of the principal to the same extent the principal could make those decisions if he or she had decisional capacity.
755 ILCS 45/4-1 through 4-10 — Illinois Power of Attorney Act, Article IV
Who Decides If You Do Not Have a Healthcare POA?
Without a healthcare power of attorney, Illinois law uses a statutory surrogate decision-making hierarchy under the Health Care Surrogate Act (755 ILCS 40/25). Decisions fall to the following priority list: (1) guardian of the person, (2) spouse, (3) any adult child, (4) either parent, (5) any adult sibling, (6) any adult grandchild, (7) a close friend, (8) guardian of the estate. This list may not match your preferences. Additionally, if multiple people share the same priority level (such as several adult children), they must agree—and disagreements can lead to conflict, delays, and even court intervention. A healthcare power of attorney lets you choose the one person you trust most.
What Decisions Can Your Healthcare Agent Make?
Your healthcare agent has broad authority to make medical decisions on your behalf unless you specifically limit their powers in the document. Understanding the scope of this authority helps you appreciate how important it is to choose the right person and to have clear conversations about your values and preferences.
Scope of Healthcare Agent Authority
Your agent can consent to, refuse, or withdraw consent for any medical treatment, procedure, or service. This includes surgeries, diagnostic tests, medications, therapies, blood transfusions, and any other medical intervention. The agent’s decisions carry the same legal weight as if you made them yourself. Your agent should base these decisions on your known wishes, values, and any instructions you have provided. If your wishes are not known, the agent must act in your best interest.
Choosing the Right Healthcare Agent
The person you choose as your healthcare agent will potentially make life-and-death decisions on your behalf. This is not a symbolic appointment—it is a deeply consequential one that requires careful consideration of several factors.
The most important quality in a healthcare agent is the willingness and ability to advocate for your wishes, even when those wishes are difficult, controversial, or different from what the agent would choose for themselves. Your agent must be able to tell doctors to stop treatment if that is your wish, even when family members are begging for more intervention. They must be able to authorize aggressive treatment if that is what you want, even when others think it is futile. This requires emotional strength, clarity of purpose, and an understanding of your values that only comes from honest conversations.
Healthcare crises are emotionally overwhelming. Your agent will face pressure from doctors presenting options with uncertain outcomes, family members with strong opinions, and their own grief and fear. The right agent can absorb this pressure and still make decisions that honor your wishes. Someone who tends to freeze under stress, defer to authority figures regardless of your instructions, or get overwhelmed by emotional conflict may not be the right choice, no matter how much you love and trust them in other contexts.
Your agent must be reachable. Medical decisions sometimes need to be made within hours or even minutes. Choose someone who can be contacted quickly and who can get to the hospital or care facility when needed. Geographic proximity is not essential (many decisions can be communicated by phone), but it helps. If your primary agent travels frequently, lives far away, or has a demanding schedule that makes them difficult to reach, ensure your successor agent is more accessible.
Your agent should understand your views on quality of life, pain management, end-of-life care, religious or spiritual considerations, and the role of medical intervention. The best way to ensure this understanding is through direct, detailed conversations about hypothetical scenarios. Share your living will with your agent and discuss the reasoning behind each choice. The more your agent understands your values, the better equipped they are to handle situations your documents may not specifically address.
Consider the family dynamics that will surround your agent during a crisis. If you choose one adult child over others, will the unchosen children accept and cooperate with the agent’s decisions? If you choose a friend or partner over a family member, will that create conflict that undermines your agent’s effectiveness? While you should not let family politics dictate your choice, it is worth considering whether your agent will have the support—or at least the acceptance—of other important people in your life.
How to Create a Valid Healthcare POA in Illinois
1
Determine the Scope of Authority
Decide whether to grant your agent broad, unlimited authority (recommended for most situations) or to include specific limitations. Common limitations might include restricting your agent from authorizing certain procedures that conflict with your religious beliefs, requiring consultation with specific family members before certain decisions, or limiting authority regarding mental health commitments. Most attorneys recommend broad authority with guidance provided through your living will and personal conversations rather than restrictive limitations that might prevent your agent from acting in an unforeseen situation.
2
Choose Your Agent and Successors
Select a primary agent and at least one (preferably two) successor agents. Illinois law prohibits your attending physician, or an employee of your attending physician, from serving as your healthcare agent unless they are related to you by blood, marriage, or adoption. Similarly, an owner or employee of a residential care facility where you reside cannot serve as your agent unless related to you. These restrictions exist to prevent conflicts of interest.
3
Execute the Document Properly
Under Illinois law (755 ILCS 45/4-5), a healthcare power of attorney must be signed by the principal and witnessed by one adult witness. The witness must not be the agent. While notarization is not legally required for a healthcare POA in Illinois, it is strongly recommended to enhance the document’s credibility and prevent challenges. Many practitioners include notarization as standard practice.
4
Have Your Agent Sign the Acceptance
Illinois law requires the agent to sign an acceptance of their appointment, acknowledging that they understand their fiduciary duties, the principal’s right to revoke, and the agent’s obligation to act in accordance with the principal’s wishes. This acceptance can be signed at the same time as the document or later, but it must be signed before the agent acts under the power of attorney.
5
Discuss Your Wishes Thoroughly With Your Agent
This step is not a legal requirement, but it is arguably the most important step in the entire process. Sit down with your agent and discuss: what quality of life means to you, when you would want life-sustaining treatment continued and when you would want it stopped, your views on pain management (including whether you would accept reduced consciousness for pain relief), your religious or spiritual beliefs regarding medical care, specific scenarios you have thought about (coma, advanced dementia, terminal cancer), and your preferences for care settings (home vs. facility, specific hospitals or doctors).
6
Distribute Copies
Provide copies to your agent and successor agents, your primary care physician, your hospital (for their records), your living will and HIPAA authorization holders, close family members who should be aware, and any care facility where you reside or receive regular treatment. Keep the original in an accessible location—not in a safe deposit box that may be inaccessible during an emergency.
Healthcare POA vs. Living Will vs. HIPAA Authorization
These three documents form the foundation of advance healthcare planning, and each serves a distinct but complementary purpose.
| Feature | Healthcare POA | Living Will | HIPAA Authorization |
|---|---|---|---|
| What It Does | Appoints a person to make healthcare decisions | Provides written instructions for end-of-life care | Allows designated people to access medical records |
| When Active | When you cannot make or communicate decisions (any medical situation) | Only when you have a terminal condition or are permanently unconscious | Immediately upon signing |
| Decision Authority | Broad — all healthcare decisions | Narrow — life-sustaining treatment only | None — information access only, not decision-making |
| Flexibility | High — agent can respond to unforeseen situations | Low — limited to scenarios and treatments specified | Moderate — covers all health information or can be limited |
| Key Limitation | Only as good as the agent you choose and the conversations you have | Cannot cover every possible scenario; may be ambiguous in complex situations | Does not authorize anyone to make decisions, only to receive information |
| Do I Need It? | Yes — essential for everyone over 18 | Yes — provides critical guidance alongside the healthcare POA | Yes — ensures your agent and family can access records without delay |
The Three-Document Approach Is the Standard of Care
The combination of a healthcare power of attorney, a living will, and a HIPAA authorization provides comprehensive healthcare planning. The POA designates a decision-maker. The living will provides specific guidance for end-of-life situations. The HIPAA authorization ensures information flows freely to your agent and family. Together, they cover virtually every healthcare scenario you might face. Most estate planning attorneys prepare all three documents as part of a single advance directive package.
Revoking Your Healthcare Power of Attorney
You can revoke your healthcare power of attorney at any time while you have the capacity to do so. Illinois law recognizes several methods of revocation:
Execute a signed, written statement revoking the healthcare power of attorney. Provide copies to your former agent, your physicians, any care facilities, and family members. This is the most clearly documented method and is always recommended.
You can revoke your healthcare power of attorney orally by notifying your attending physician. The revocation must be documented in your medical record. While legally valid, oral revocation can be harder to prove and communicate to all relevant parties.
Executing a new healthcare power of attorney that expressly revokes all prior healthcare powers of attorney effectively replaces the old document. Always include explicit revocation language in new documents. Date all documents clearly so the most recent version can be identified.
Destroying the physical document constitutes revocation. However, copies may exist with agents, physicians, hospitals, and family members. Destruction alone may not be effective if others rely on their copies. Always accompany destruction with written or oral notification to all holders.
Special Situations and Considerations
Once a child turns 18, parents have no legal authority to make healthcare decisions for them or access their medical information. This surprises many families during a medical emergency. Every young adult—especially those leaving home for college, military service, or independent living—should execute a healthcare power of attorney naming a trusted parent or other person. This is one of the simplest and most important things an 18-year-old can do, and many estate planning attorneys will prepare young adult healthcare documents at minimal cost alongside parents’ estate plans.
Many people assume their spouse automatically has the right to make medical decisions for them. While Illinois does place spouses high on the statutory surrogate list, they are not first—a court-appointed guardian takes priority. Moreover, in blended families, the spouse’s authority under the surrogate act may be challenged by children from prior relationships. A healthcare power of attorney removes all ambiguity by specifically naming your spouse (or whomever you choose) as your agent.
If you are divorced and your former spouse was named as your healthcare agent, revoke and replace that document immediately. Under Illinois law, if you name your spouse as your healthcare agent and subsequently divorce, the designation of your former spouse as agent is automatically revoked. However, relying on this automatic revocation is risky—healthcare providers may not know about the divorce, and the former spouse may still have a copy of the document. Execute a new healthcare POA with your chosen agent after any divorce.
If you do not have a spouse, children, or other close family members, a healthcare power of attorney is even more important. You can name a trusted friend, neighbor, professional fiduciary, or spiritual advisor as your agent. Without any designated agent and without close family, healthcare decisions may fall to a court-appointed guardian—a stranger. Anyone without family connections should prioritize this document.
If you have been diagnosed with a condition likely to affect your capacity in the future (such as Alzheimer’s disease, Parkinson’s disease, or ALS), executing a healthcare power of attorney immediately is critical. Your document should include detailed guidance about the progression of your condition and your preferences at each stage. The earlier you create this document and have conversations with your agent, the more guidance your agent will have when difficult decisions arise.
Frequently Asked Questions
Generally, your healthcare agent must follow the instructions in your living will. If your living will says to withhold life-sustaining treatment in a terminal condition, your agent should honor that directive. However, if a situation arises that your living will does not address, your agent uses their judgment based on your known values and wishes. If there is a genuine conflict between your living will and what your agent believes you would want in an unanticipated situation, courts generally give weight to the most recent expression of your wishes.
While it is technically possible to split healthcare decision-making authority between different agents, it is generally not recommended. Medical situations often require fast, coordinated decisions, and splitting authority creates confusion and potential for conflict. A better approach is to name one primary agent with clear instructions and guidance about how you want different types of decisions handled.
This is why naming successor agents is critical. If your primary agent cannot be reached, your successor agent steps in. If no agent is available, decisions fall to the statutory surrogate hierarchy. Hospitals make reasonable efforts to contact your designated agent, but in true emergencies where delay would be dangerous, physicians may proceed with life-saving treatment regardless of your advance directives.
Healthcare providers are generally required to follow the decisions of a validly appointed healthcare agent. However, physicians may refuse to follow an agent’s directive if they believe it constitutes medically inappropriate treatment. In such cases, the physician must make reasonable efforts to transfer the patient to a provider who will honor the agent’s decision. Illinois law protects providers who follow an agent’s instructions in good faith.
An Illinois healthcare power of attorney does not expire unless you include an expiration date in the document (which is generally not recommended). It remains effective until you revoke it or until you pass away. However, it is good practice to review and re-execute the document every few years to confirm your choices and update your agent designations if circumstances have changed.
Healthcare Power of Attorney: Key Points
- A healthcare power of attorney lets you choose who makes medical decisions for you when you cannot—without it, Illinois statutory rules determine the decision-maker
- Your agent has broad authority over all healthcare decisions unless you specifically limit their powers
- Every adult over 18 needs this document, including young adults leaving home for college or independent living
- Choose an agent based on their willingness to advocate for your wishes, emotional resilience, and availability
- A healthcare POA works best when combined with a living will (for end-of-life instructions) and a HIPAA authorization (for medical information access)
- Illinois requires one witness for execution; notarization is recommended but not legally required
- Have detailed, honest conversations with your agent about your values, preferences, and specific scenarios
- Review and update your document after major life changes such as marriage, divorce, new diagnoses, or changes in your relationship with your agent
Take This Critical Step Today
A healthcare power of attorney is not a document you create for old age—it is a document you need the moment you turn 18. Accidents, sudden illnesses, and unexpected medical emergencies do not wait for a convenient time. Having your healthcare agent designated and prepared ensures that someone you trust is making decisions that reflect your values when you cannot speak for yourself.
Our firm prepares healthcare powers of attorney as part of every comprehensive estate plan for Illinois clients. We help you choose the right agent, customize the document to reflect your specific wishes and values, coordinate your healthcare POA with your living will and HIPAA authorization, and ensure your advance directive package is properly executed and distributed. Schedule a consultation to discuss your healthcare planning needs and protect yourself and your family.