Maryland Medical Power of Attorney: How to Appoint a Healthcare Agent

Maryland Does Not Have a Separate "Medical Power of Attorney"

If you search for a Maryland medical power of attorney, you will not find a standalone document. That is because Maryland bundles the healthcare agent designation into Part I of the statutory advance directive, governed by the Health Care Decisions Act.

In practice, "medical power of attorney," "healthcare proxy," and "healthcare agent" all refer to the same thing in Maryland: the person you name in Part I of your advance directive to make medical decisions when you cannot.

What Your Healthcare Agent Can Do

Under Maryland law, your healthcare agent receives broad authority:

• Consent to or refuse any medical treatment
• Choose healthcare providers and treatment facilities
• Select nursing homes and hospice programs
• Make decisions about organ donation
• Authorize final disposition (burial, cremation)
• Access your medical records

This authority is not limited to end-of-life situations. Once activated, your agent can make any healthcare decision you could make for yourself.

When the Agent's Authority Kicks In

Maryland offers two activation options:

Default (incapacity-triggered): Your agent's authority begins only after two physicians certify in writing that you lack decision-making capacity. At least one physician must have examined you within two hours of signing the certification. If you are unconscious or completely unable to communicate, only one certifying physician is required.

Immediate authority: If you initial the optional clause, your agent's power starts the moment you sign the advance directive. However, your own decisions override your agent's as long as you retain capacity.

Choosing immediate authority can be useful in situations where capacity fluctuates — such as early-stage dementia — because it avoids delays in getting the two-physician certification during a medical crisis.

Who Cannot Serve as Your Agent

Maryland law prohibits the owner, operator, or employee of a healthcare facility where you receive care from serving as your healthcare agent — unless that person is also a close relative. This prevents conflicts of interest in institutional settings.

You can (and should) name one or two backup agents in case your primary agent is unavailable, unwilling, or unable to act when needed.

Medical POA vs. Financial POA: Critical Differences

This is where Maryland law creates the most confusion. A healthcare power of attorney and a financial power of attorney have completely different execution requirements:

Many Marylanders delay completing their healthcare directives because they believe a notary is required. It is not — but your financial power of attorney does need one. Completing both documents in the same session with a notary present is efficient, even though only the financial document legally requires it.

Why Naming an Agent Is Not Optional

Without a designated healthcare agent, Maryland's rigid surrogate hierarchy determines who makes your medical decisions. The priority runs: court-appointed guardian, then spouse or domestic partner, then adult children (all holding equal authority), then parents, then adult siblings, then friends or relatives who file an affidavit.

The most dangerous scenario is when multiple surrogates of equal rank disagree. If two adult children cannot agree on whether to withdraw life support, Maryland law prohibits physicians from acting until the dispute is resolved — either through the hospital's ethics committee or through a circuit court guardianship petition that can cost thousands of dollars and take weeks.

Naming one clear healthcare agent eliminates this deadlock entirely.

The Maryland Advance Directive & Living Will Kit guides you through the agent selection process, explains both activation options with real scenarios, and includes the witness eligibility checklist to ensure your designation is legally enforceable.

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