By Martina Sczesny, MD

“Expect the unexpected,” goes the old saying. Despite this, most of us prefer not to think about life-changing events like a serious illness or accident. Yet a vehicle could come out of nowhere, perhaps with a drunk driver at the wheel, or a slippery New England road might spin an 18-wheeler’s tires out of control. In an instant, your life could be on the line. An unexpected illness could suddenly change your life and your ability to think for yourself, or a progressive, debilitating condition could eventually compromise your control over decision-making.

If you were unable to speak for yourself, who would you trust to care for your body, your well-being, and your wishes?

Martina Sczesny, MD
Martina Sczesny, MD

Many of us have seen extremely tragic examples of a person’s wishes NOT being carried out, simply because no one had been legally appointed as their health-care agent. In Vermont, there is no law that automatically gives the decision-making power to a spouse or other loved one. It is the hope of the Brattleboro Memorial Hospital Ethics Committee to explain, in a series of short articles over the next few months, how to make sure your wishes are honored should you ever become unable to communicate them.

Today, we will explain the immediate steps you can take to appoint a trusted person to ensure that medical staff follows your wishes, using a simple, two-page form called “Appointment of a Health Care Agent.” A health care agent is someone you trust, someone who knows and is willing to follow what your wishes would be, in case you become unable to explain those wishes to medical personnel. This “agent” must be willing to make clear to doctors and nurses what those wishes are. Once the form is completed, your health care agent has the legal authority to make critical decisions on your behalf if you are unable to do it yourself. Filling out this form takes less than ten minutes, but the more you discuss your wishes with your agent, the better they will understand them. The form requires two witnesses to guarantee that you are freely appointing this agent without any pressure or undue influence from anyone. Parents, spouses, siblings, children, or grandchildren may not serve as witnesses. The agent is only called upon if you are found not to have the capacity to make your own decisions regarding your health care.

The form can be downloaded and printed out from The Vermont Ethics Network website. You can do this on your own and you do not need to hire a lawyer to complete the paperwork. Copies of the form are usually added to the person’s medical chart, given to their primary care provider, to family members and hospital staff, as well as to the health care agent themselves.

A few minutes of your time can ensure that your health care wishes are carried out in case of an emergency.

Please take a moment to appoint a Health Care Agent today.

Next month we will discuss another important step you can take: filling out a form called an Advanced Directive (sometimes called a Living Will), in which your preferences for medical treatment are listed. Medical providers are bound by this form to take (or NOT take) the steps you want, should you be unable to communicate them yourself.

This series is written by the Brattleboro Memorial Hospital Clinical Ethics Committee. Should you have questions or suggestions for these monthly articles, please contact: Martina Sczesny, MD – Chair, Clinical Ethics Committee, at

The BMH Clinical Ethics Committee provides assistance to those persons directly involved in a patient’s care, to identify, analyze, and resolve ethical problems pertaining to the care of the patient. This may include the patient, their family, and medical and hospital personnel.