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Who can invoke a healthcare proxy in Massachusetts?

I work at a nursing facility in Massachusetts but I'm not a doctor or a nurse. I get a little worried sometimes because once in a while the nurses will say that a patient is incapacitated and start talking to the resident's health care agent without doing anything in writing. I did a health care proxy myself and I was told that only the doctor can invoke the proxy. Is that right? Thank you.

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Yes, you are correct.  This whole area of law is covered by Massachusetts General Laws Chapter 201D.  Section 6 of that chapter states: (1) the health care agent's authority does not begin until the principal lacks the capacity to make health care decision; (2) that determination can only be made by the attending physician; (3) in a writing that explains the cause, nature and likely duration of the incapacity; and (4) the writing must be placed in the medical record of the patient.  Section 1, the definitions for Chapter 201D, defines attending physician narrowly as the physician with primary responsibility for the patient's treatment and care.  The term does NOT include nurses or other staff of the facility.

So, the nurses at your facility should not act as though the the proxy has been invoked, and should not ask any other party to make medical decisions for the patient, until the physician invokes the proxy.  This is an important point, because a patient who is not consulted about her care cannot give the required informed consent.  Without that consent, the treating facility becomes vulnerable to legal action.  Hope that helps.

I fought a nursing home in court for two months only to find out they had invoked with a nurse practitioner and I found out that is illegal. Does any lawyer want my case. No, my mother was not hurt while in the facility in Pittsfield, but they broke the law that way and other ways. Email me at

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