Health Care Proxy New Jersey: Naming a Healthcare Representative for Your Parent

The ICU doctor is asking whether to continue aggressive treatment or transition to comfort care. Your parent is sedated and cannot respond. Three siblings are in the room, each with a different opinion. Without a designated healthcare representative, the hospital may follow its own protocols — or worse, require a court order before anyone can authorize a change in treatment direction.

What "Healthcare Representative" Means in New Jersey

New Jersey doesn't use the term "healthcare proxy" in its statute, though the concept is identical. Under the Advance Directives for Health Care Act (N.J.S.A. 26:2H-53 et seq.), your parent designates a healthcare representative through a Proxy Directive — the person legally authorized to make medical decisions when the patient lacks decision-making capacity.

This is different from other states that use separate "healthcare proxy" or "medical power of attorney" forms. In New Jersey, the healthcare representative designation is part of the Advance Directive for Health Care, though it can be the sole component if your parent chooses not to include an instruction directive (living will).

What Authority the Healthcare Representative Has

Once the advance directive becomes operative (delivered to the physician + clinical determination of incapacity), the representative can:

• Consent to or refuse medical treatments, surgeries, and procedures
• Authorize or decline admission to hospitals, nursing facilities, or rehabilitation centers
• Access medical records and discuss treatment plans with physicians
• Make decisions about life-sustaining treatment consistent with the patient's known values
• Direct burial or cremation arrangements (only if the document is notarized)

The representative is bound by the substituted judgment standard — they must make the decision the parent would have made, not what they personally believe is best. If the parent's wishes are unknown, the representative applies the best interests standard.

Naming Successor Representatives

What happens if your designated representative is unavailable, incapacitated, or unwilling to serve when the moment comes? New Jersey law allows naming successive backup agents in the advance directive. If the primary representative cannot act, authority passes automatically to the next named person without court intervention.

Name at least two successors. Life circumstances change — the person you name today may move across the country, develop health problems of their own, or face a conflict of interest (such as being the attending physician at the facility). Successor designations prevent a crisis from escalating into a court petition for guardianship.

Execution Requirements

The Proxy Directive (naming a healthcare representative) follows the same execution rules as the full advance directive:

• Two witnesses: Who attest the declarant is of sound mind and free from duress. The designated healthcare representative cannot serve as a witness.
• OR Notarization: Before a notary public, attorney-at-law, or authorized oath officer. If burial/cremation authority is included, notarization is mandatory.

Healthcare Representative vs. HIPAA Authorization

A common source of confusion: the healthcare representative designation does not automatically grant access to your parent's medical information while they still have capacity. The advance directive only activates upon a clinical determination of incapacity.

For immediate access to medical records, discharge plans, and physician communications — even while your parent is still competent — a separate standalone HIPAA authorization is needed. This allows providers to share health information with you regardless of the parent's current cognitive status.

Families often discover this gap when their parent is hospitalized but still technically conscious and oriented. The parent signed an advance directive naming their child as representative, but the hospital's privacy officer explains that the directive isn't operative yet because the patient can still make their own decisions. Meanwhile, the family can't access test results or discuss the treatment plan with the care team.

The Practical Difference From a Financial POA

The healthcare representative has zero authority over financial matters. They cannot:

• Access or manage bank accounts
• Pay bills or handle insurance claims
• File Medicaid applications
• Sign admission agreements that create financial liability
• Manage property or investments

These require a separate Durable Financial Power of Attorney. Many families make the mistake of assuming one document covers everything — then discover mid-crisis that the person authorized to make medical decisions has no ability to arrange payment for the care they just authorized.

Getting Both Authorities Established

The New Jersey Power of Attorney & Guardianship Kit covers the healthcare representative designation, successor agent provisions, the standalone HIPAA authorization for immediate information access, and the durable financial power of attorney — ensuring your family has complete legal authority across both medical and financial domains.

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