Indiana Medical Power of Attorney: How to Appoint a Healthcare Decision-Maker

If someone you love is hospitalized and cannot speak for themselves, the question of who makes medical decisions becomes urgent. In Indiana, the answer depends entirely on whether they appointed a Health Care Representative before losing capacity.

Without one, decisions fall to a statutory hierarchy where majority votes among relatives control. With a properly appointed representative, one trusted person has clear legal authority — no committee, no family vote, no hospital delays.

Medical Power of Attorney vs. Health Care Representative

Here is the critical distinction most people miss: since January 1, 2023, Indiana no longer recognizes a separate "medical power of attorney" document. Senate Enrolled Act 204 consolidated everything into a single advance directive that includes the Health Care Representative (HCR) appointment.

If you executed a general durable power of attorney after December 31, 2022, and included healthcare authority using the old statutory language, those healthcare clauses are void. The old form no longer works for medical decisions. You need a unified advance directive under Indiana Code § 16-36-7.

Documents executed before 2023 under the old statutes remain valid, but anyone creating or updating their healthcare planning now must use the current framework.

What Authority Your Representative Gets

The appointed HCR receives broad statutory powers once a physician certifies in writing that you lack capacity to make or communicate treatment decisions. Your representative can:

• Consent to or refuse any medical procedure
• Manage hospital admissions and discharges
• Access your protected health information
• Make decisions about life-sustaining treatment (subject to your living will preferences)
• Authorize or decline participation in clinical trials

The HCR must act in good faith, making the decisions you would have made. If your wishes are unknown, they must act in your objective best interests. You can also specify whether their authority activates immediately or only upon certified incapacity.

Who Can (and Cannot) Serve

Indiana law does not restrict who you can appoint as your HCR. Any competent adult can serve — a spouse, adult child, sibling, trusted friend, or anyone else you choose.

However, there are practical considerations. Your HCR cannot serve as a witness to the document. And if your advance directive includes a living will declaration about withdrawing life support, the witness restrictions tighten significantly — your HCR, spouse, children, and potential heirs are all disqualified from witnessing.

You should name at least one alternate representative in case your primary choice is unavailable, unwilling, or incapacitated when needed. Without a backup, and with your primary representative unreachable, decisions revert to the default consent hierarchy.

The Default Hierarchy You Are Bypassing

When someone loses capacity without an appointed HCR, Indiana Code § 16-36-1-5 establishes this decision-making order:

1. Judicially appointed guardian
2. Spouse (disqualified if legally separated or divorce is pending)
3. Majority of adult children
4. Living parents
5. Majority of adult siblings
6. Living grandparents
7. Majority of adult grandchildren

At every tier, if multiple people share the same priority level, a majority vote controls. One dissenting sibling out of three still loses. This default hierarchy is exactly what causes the painful hospital stalemates families dread — and exactly what a properly appointed HCR prevents.

How to Execute the Appointment

The HCR appointment must be part of a properly executed advance directive — written, dated, signed, and validated before either a notary public or two qualified adult witnesses. Remote execution via live audio-visual call is permitted under SEA 204, with paper counterparts compiled within 10 business days.

The Indiana Advance Directive & Living Will Kit covers the full HCR appointment process with witness eligibility checklists and scope-of-authority templates, so your representative knows exactly what they can and cannot decide.

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