Does Guardianship Override Medical Power of Attorney?

Sometimes a person can no longer make their own decisions and needs another person designated to do so. The authority can be partial, as in a medical power of attorney, or comprehensive, as is the case with guardianship.

A medical power of attorney (MPOA) is a legal document that designates someone to make medical decisions for an incapacitated individual. The authority becomes active when the individual who made the designation cannot make care decisions. Some MPOA documents transfer total control over medical decisions to the selected person, while others limit options. An MPOA is often accompanied by a living will, which outlines the person’s medical treatment preferences.

States govern medical power of attorney grants, and the various names and rules can be confusing. For example, some states call the individual a healthcare proxy instead, and some have different requirements depending on whether the person whose care is concerned is a minor or an adult. In addition, in some states, an MPOA is not valid unless there is a living will or advance medical directive that details the principal’s wishes.

Guardianship is a broad responsibility.

A legal guardian is appointed or confirmed by a court, and that person has the authority to make financial and personal decisions for the person for whom they are the guardian (called their ward). A guardian is sometimes designated for an adult who cannot make valid decisions regarding their finances or other concerns such as housing or legal matters. While minors may often need guardians due to their legal incompetence, adults typically only have guardians appointed if they can't demonstrate the capacity to make rational decisions.

Who can be a guardian or hold an MPOA?

A guardian might be a family member or close friend in some cases. For example, family or business associates sometimes petition a court to appoint a guardian after witnessing the individual's cognitive decline or other evidence of incapacitation. If no obvious family member is available (or if more than one person is vying for the role), the court may designate a neutral party to act as guardian.

Which role is paramount?

In most cases, the decision of a medical power of attorney will supersede a guardian’s determination if both exist for the same person and the issue is medical. One reason is that the principal selected their MPOA representative, while they may not have been involved with determining guardianship. Furthermore, as noted above, the MPOA typically includes detailed instructions on the individual’s preferences. In contrast, the guardian is unlikely to be privy to such personal information.

It’s helpful to note that you may lessen the potential need for a court-appointed guardian if you designate a medical and general power of attorney while you are capable. Then, if you create a living will to list your medical and financial preferences, the person you have designated will have the proper authority and the necessary information to fulfill your stated wishes.