Last week I was talking to a friend who was struggling with a big decision: who to choose as her healthcare proxy (also known as a healthcare agent, or medical decision maker.) Like most of us, she knows she needs one and considers it important.
“What’s holding you back?”, “Is it just too hard to find the time or is it something else?”
“Actually, I just don’t know who to choose,” she said. She didn’t think her husband would be a good choice because of his health issues. She worried it was too much to ask of her eldest daughter. She considered other people in her life, but...it felt complicated. She went through the pros and cons of each person and still didn’t feel like she had a clear choice.
I encouraged her to make the decision that felt “most right”, get the documents created, and change them later as things change in her life.
Easy to say. Unfortunately, it probably wasn’t very helpful.
5-minute Fix: Use a decision matrix to choose a healthcare proxy.
This week, I remembered a tool I often use as a product manager: the decision matrix. A decision matrix allows you to compare multiple choices against several rating criteria.
I use this type of decision-making tool in my professional life to analyze trade-offs and make complex decisions. Why not apply the technique to a personal decision like "Who should I choose as my healthcare proxy?"
In the example below, the key questions to ask about your potential medical decision maker are in the first column. In column two, a "weight" is assigned. This allows you to customize the decision by giving the factors you consider most important a higher weight. In columns three and four are the names of each person you're considering as a medical decision maker.
Use the matrix by evaluating each person against each criteria, entering a value between 1 and 5 in each cell, where 5 is the "best fit" or "most likely" value.
Finally, the scores are calculated by multiplying the weighting criteria by the value.
Healthcare Power of Attorney Decision Matrix
Criteria | Weighting | April K | Sam R |
|---|---|---|---|
How willing would they be to take on the role? | 3 | 5 | 3 |
How likely are they to carry out your wishes (even if different from their own)? | 3 | 4 | 5 |
How assertive are they? Will they stand up for you, if necessary? | 4 | 3 | 4 |
How comfortable would they be speaking with medical providers and asking questions? | 5 | 5 | 3 |
Can they remain calm in a crisis and make quick decisions if required? | 5 | 5 | 3 |
How well do they understand your health condition (if any)? | 2 | 5 | 3 |
Do they live near enough to be effective in the role? | 3 | 3 | 3 |
Score | Cell | 107 | 99 |
Common Questions
What if I don't have a family member or friend to ask to be my healthcare proxy?
If you don’t have a family or friend to ask (or if you simply want someone that doesn’t have an emotional involvement with you to help make decisions), consider naming a professional fiduciary. Note that your medical professionals cannot be your healthcare agent.
What if your family usually makes healthcare decisions as a group or by consensus?
Many families make big decisions together. If your family operates this way, I recommend naming ONE person to facilitate discussions and speak for the group. If you expect sibling rivalries or other family conflicts may complicate decisions, it’s all the more important to specify roles and responsibilities clearly and talk about it with your family! You might be surprised how long those “mom would have wanted…” discussions can linger.
If you use the decision matrix, I'd love to hear from you. Did it help?
Take care,
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