Maine Healthcare Proxy Rules: How to Designate a Health Care Agent

Maine Calls It a "Health Care Agent," Not a Proxy

If you search for "healthcare proxy" in Maine, you will find the term used informally — but the statute uses different language. Under the Uniform Health Care Decisions Act (Title 18-C, Section 5-803), the person you designate to make medical decisions on your behalf is your health care agent. The document that creates this designation is your advance health care directive.

This is not just a naming convention. Using the correct statutory terminology ensures your document is recognized without question by hospitals, physicians, and long-term care facilities across the state.

Who Can Serve as Your Health Care Agent

Almost anyone can be your agent. There is one statutory prohibition: an owner, operator, or employee of a residential long-term care facility where you currently receive care cannot serve as your agent — unless they are related to you by blood, marriage, or adoption (18-C M.R.S. Section 5-803(2)).

Beyond the legal restriction, practical considerations matter more than most people realize:

• Geographic proximity: Your agent needs to be physically available during a crisis. A sibling across the country may share your values but cannot get to the ICU at 2 a.m.
• Emotional resilience: Your agent may need to authorize the withdrawal of life support. Not everyone can handle that conversation with a medical team.
• Willingness to advocate: Hospitals are institutions with their own priorities. Your agent needs to be someone who will push back when your documented wishes conflict with institutional recommendations.

Always designate an alternate agent in case your primary choice is unavailable, incapacitated, or unwilling to serve when the time comes.

What Authority Does Your Agent Actually Have

Once activated, your health care agent can:

• Consent to or refuse any medical treatment, including life-sustaining interventions
• Access your complete medical records
• Make decisions about diagnostic procedures, surgical interventions, and medications
• Authorize transfer between healthcare facilities
• Make end-of-life care decisions consistent with your documented wishes

Your agent is legally bound to follow the specific instructions you included in your directive. If your wishes on a particular situation are unknown, the agent must act in your best interest based on their understanding of your values.

What your agent cannot do: Make decisions that contradict your explicit written instructions. If you documented that you do not want artificial nutrition under any circumstances, your agent cannot override that preference.

When Your Agent's Authority Activates

By default, your health care agent's authority begins only when your primary physician formally determines that you lack the capacity to make your own medical decisions.

Capacity under Maine law means the ability to:

• Understand your diagnosed condition
• Evaluate the risks, benefits, and alternatives of proposed treatments
• Comprehend the consequences of refusing treatment
• Communicate a decision

You can change this default. Your directive can include a provision making the agent's authority effective immediately upon signing, rather than waiting for an incapacity determination. Some people choose this option if they travel frequently or want their agent to be able to communicate with medical providers on their behalf at any time.

The Signing Requirements

Designating a health care agent requires the same formalities as the rest of your advance directive:

• Written document, signed by hand — electronic signatures are prohibited
• Two adult witnesses who sign in your physical presence
• Your agent cannot witness the document — neither can your alternate agent
• No notary required for the healthcare agent designation itself (but notarization is needed if you also grant burial/cremation authority in the same document)

How to Revoke or Change Your Agent

You can revoke your agent's authority at any time, by any means that clearly communicates your intent. This includes:

• Signing a written revocation
• Verbally telling your supervising healthcare provider
• Executing a new advance directive (which automatically supersedes the old one)

After revoking, physically mark old copies as "REVOKED" and notify every entity that has a copy — your agent, alternate agent, physicians, hospitals, and care facilities. Maine does not have a centralized registry, so distribution falls entirely on you.

What Happens If You Do Not Designate an Agent

If you become incapacitated without naming a health care agent, Maine's surrogate hierarchy kicks in. Your primary physician must locate a surrogate decision-maker in this order: spouse, adult partner, adult child, parent, adult sibling, adult grandchild, adult niece or nephew, adult aunt or uncle, any adult relative, or any adult who has shown special concern for you.

The problem: if multiple people in the same tier disagree — say three adult children split on whether to continue treatment — and the split is even, that entire tier and everyone below it is disqualified from deciding. The dispute goes to court, which means a judge who has never met you makes the call.

Naming your own agent prevents this entirely.

The Maine Advance Directive & Living Will Kit includes the statutory agent designation form, a guide to choosing and briefing your agent, and the witness eligibility checklist to make sure your signing ceremony holds up.

See more Maine guides →