New Hampshire Healthcare Proxy: Why NH Uses the DPOAH Instead

If you recently moved to New Hampshire from Massachusetts or another northeastern state, you probably have a healthcare proxy on file. You might assume it works the same way here. It doesn't — and the terminology differences are more than cosmetic.

New Hampshire does not use the term "healthcare proxy." The equivalent document is the Durable Power of Attorney for Health Care (DPOAH), and it's part of the state's combined advance directive form under RSA 137-J. Understanding the differences matters, because a Massachusetts healthcare proxy may not cover you the way you expect once you're a New Hampshire resident.

The Terminology Difference

In Massachusetts, you sign a standalone "healthcare proxy" to appoint a "healthcare agent." The document covers agent designation only — it does not include a living will or treatment instructions.

In New Hampshire, agent designation and treatment instructions are combined into a single statutory form. The DPOAH portion appoints your healthcare agent. The Living Will portion documents your specific treatment preferences. You execute both in one signing session with one set of witnesses.

The person you appoint is called a "Health Care Agent" in New Hampshire — the same title Massachusetts uses, but embedded in a different legal framework.

What the 2021 SB 74 Changes Mean for Your Agent

The 2021 amendments under SB 74 significantly expanded the default authority of a healthcare agent in New Hampshire. Unless you specifically restrict these powers in your directive, your agent can now:

• Consent to or refuse any medical treatment, including life-sustaining measures
• Request and authorize a POLST form (Provider Orders for Life-Sustaining Treatment) from your physician
• Access your medical records and communicate with your treatment team
• Make decisions about organ and tissue donation
• Authorize transfer between care facilities

This is broader than what many other states grant by default. If you're porting a Massachusetts healthcare proxy into New Hampshire, your new DPOAH may give your agent more authority than the old document did — which is generally a good thing, but you should be aware of it.

Does Your Massachusetts Proxy Still Work?

New Hampshire recognizes advance directives executed in other states under RSA 137-J:17, provided the document was validly executed under the laws of the originating state. So technically, yes — your Massachusetts healthcare proxy is still recognized.

But "recognized" and "optimally effective" are two different things. A Massachusetts proxy does not include treatment instructions, does not reference New Hampshire's specific statutory provisions, and may not grant the expanded agent authority that SB 74 provides by default. If you've established permanent residency in New Hampshire, executing a new advance directive under RSA 137-J gives you stronger, more comprehensive protection.

How to Choose Your Agent

New Hampshire law does not require your agent to be a state resident. You can appoint anyone you trust — a spouse, adult child, sibling, or close friend — regardless of where they live. The key criteria are practical, not legal:

Availability. Your agent needs to be reachable during a medical crisis. Someone who travels extensively or lives overseas may not be able to respond quickly enough.

Willingness to advocate. Healthcare decisions under pressure require someone who can push back against institutional inertia — requesting transfers, questioning treatment recommendations, and enforcing your documented preferences even when medical staff prefer a different course.

Emotional resilience. Making decisions about life-sustaining treatment for someone you love is genuinely difficult. Choose someone who can separate their own grief from your expressed wishes.

Always name an alternate agent. If your primary agent is unavailable, incapacitated, or unwilling to serve, the alternate steps in without requiring court involvement.

The Spouse Designation Trap

New Hampshire law includes an automatic revocation provision: if you designate your spouse as your healthcare agent and the marriage is subsequently dissolved or annulled, the agent designation is revoked by operation of law. This happens automatically — no separate revocation filing is needed.

The problem is that many people forget to execute a new advance directive after a divorce. Until they do, they effectively have no designated agent, which triggers the default surrogacy hierarchy. That means a court-determined priority list — not their personal choice — controls who makes their medical decisions.

The New Hampshire Advance Directive & Living Will Kit includes an agent selection worksheet that walks you through these considerations and helps you document both primary and alternate agent designations with the proper statutory language.

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