Colorado Healthcare Agent Responsibilities: What Your Medical Power of Attorney Actually Requires

Being named as someone's healthcare agent under a Colorado Medical Durable Power of Attorney is one of the most consequential responsibilities a person can accept. It means that if the person who appointed you — the principal — becomes unable to communicate, you make their medical decisions. Not advisory suggestions. Binding decisions that doctors and hospitals are legally obligated to follow.

Most people agree to serve as an agent without understanding what the role actually involves. Here is what it means under Colorado law.

What You Are Authorized to Decide

Under C.R.S. § 15-14-501, your authority as a healthcare agent covers:

• Treatment decisions — consenting to or refusing medications, surgeries, therapies, and procedures
• Hospital and facility decisions — authorizing admissions, transfers between facilities, and discharges
• Access to medical records — reviewing test results, diagnoses, and treatment plans under HIPAA
• End-of-life care — making decisions about life support, ventilation, and artificial nutrition if the principal has not left specific instructions in a living will
• Organ and tissue donation — authorizing or refusing anatomical gifts under the Revised Uniform Anatomical Gift Act
• Hospice and palliative care — transitioning from curative treatment to comfort care

Your authority does not extend to financial matters, property decisions, or anything covered by a separate financial power of attorney. It also does not cover decisions the principal has already documented in their living will — those written instructions take priority over your judgment.

When Your Authority Activates

This depends on what the principal selected on the MDPOA form:

Standing authority means you can act immediately, from the moment the document is signed. You do not need to wait for a physician to certify incapacity. This is the most common choice because it eliminates delays during emergencies.

Springing authority means your power activates only after two physicians (or one physician and one advanced practice nurse) certify in writing that the principal lacks decision-making capacity. This adds a layer of protection for the principal but can delay your ability to act by hours or days.

In either case, your authority ends the moment the principal regains capacity, revokes the MDPOA, or passes away.

Your Core Obligation: Substituted Judgment

Colorado law does not give you the right to impose your own values. Your legal obligation is "substituted judgment" — making the decision you believe the principal would make if they could speak for themselves. This means following any documented preferences in the principal's living will, drawing on conversations you have had about their values, and considering their religious beliefs, cultural background, and stated quality-of-life standards.

If you do not know what the principal would want and they left no written guidance, you default to what a reasonable person in their situation would choose — but this is the weakest position to be in as an agent. It opens decisions to challenge from other family members.

What to Do Before a Crisis Happens

The time to prepare for this role is not in the ICU hallway. If someone has named you as their healthcare agent:

Have the conversation now. Ask the principal about their preferences for ventilators, feeding tubes, CPR, hospice transition, and pain management. Ask what quality of life means to them — not in abstract terms, but specifically: "If you could not recognize your family, would you want life-sustaining treatment continued?"

Get copies of their documents. Keep copies of the signed MDPOA, living will, and any CPR Directive or MOST form. Know where the originals are stored.

Learn the healthcare system. Know which hospital system the principal uses, who their primary care physician is, and whether they have an active patient portal account. Being able to access records quickly during a crisis saves critical time.

Understand the limits. You cannot consent to certain treatments without additional legal authority (such as experimental procedures or psychiatric commitment), and you cannot make decisions that conflict with the principal's documented wishes. If a physician believes your decision is not in the patient's best interest, they can request an ethics committee review.

Prepare for the Role

The Colorado Advance Directive & Living Will Kit includes an agent briefing worksheet designed to walk through the conversation between the principal and their chosen healthcare agent, covering values, preferences, and practical logistics so you are prepared rather than guessing when the call comes.

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