Many attorneys actively discourage their clients from selecting more than one agent at a time because it has the potential to make decision-making in crisis more difficult. If there is more than one agent serving at any given time than there is always the possibility that they may disagree and/or give conflicting instructions.
There are typically two solutions of to this problem. One is to pick an odd number of agents and allow a majority of agents in agreement to overrule a minority that disagrees. This allows for a relatively streamlined way for disputes to be settled. The alternative is to require consensus among all the agents for all decisions. The advantage of requiring consensus among agents is that it requires families to come to a joint decision and take joint responsibility for those decisions. Otherwise there is a risk that one agent for example, one your adult children may simply be out-voted about the decision to try a treatment method and may harbor resentment against the other agents or even blame them, instead of your health crisis, for your death.
Such resentments can, of course, still come up if you choose to make just one child an agent in the first place but, in our experience, they tend to be magnified if the minority opinion child has been given the agent role in the first place just to find that they are, in fact, powerless to make actual decisions. Resentments can also be magnified where one of the agents has always felt a bit ganged up on by the others such as a black sheep sibling. And it is almost always the child who is most geographically distant and/or emotionally distant from the parent who is the least likely to face the reality of a terminal illness or hopeless medical crisis. They have simply had less time and information to come to terms with the situation and have had the least time to say their good byes or to achieve the sort of emotional closeness that they had hoped would eventually come with time.
The disadvantage of requiring consensus is that it may take a while for the agents to agree among themselves or mediate their disagreement. During that time you may either not be getting treatment that the majority of your agents think you should get or be getting treatment that the majority think should have been suspended. In the end, it is possible that time, nature, and/or science may make the decisions for you while your family fights it out. In addition, if everyone must agree then everyone needs to be in the loop and probably at the treatment facility. For people whose agents have busy careers, competing family demands, or live far away that can become somewhat of a logistical nightmare.
We usually recommend that if consensus is required that it be the consensus of the agents present at the treatment facility in order to preserve some flexibility for the family. But that may result in someone getting left out of the loop and out of the decision-making. To a certain degree the decision about number of agents and methods of decision making may come down to how you balance in your own mind your desire to preserve family harmony and have everyone feel empowered in the process versus your desire to have your wishes respected or the best decisions made.
In our experience, it works best if you can select one agent to serve at a time. Other close family members or friends should, if possible, know who the selected agent is, and, if possible, have that choice communicated to them in as loving and affirming a way as possible. (For example by explaining that the choice was not based on a lack of trust or love for the other possible agents but selected was based on who was able to come to the most doctors appointments with you now so that they would be ready in a crisis or who has the most medical experience.)
Ideally all close family members should be given copies of your health directive as well so that they know what choice you have made and have an opportunity to process them and ask questions if necessary. You may also want to talk to your selected agent and communicate any desires you might have about how they should informally consult your other family members and even your willingness to have decision-making slowed down to allow people to come to consensus where possible if that is your priority. If you do decide that having more than one agent is what is best for your family, and frequently it is, you need to take extra care to draft an advance health care directive that will provide guidance. Relying on one person’s best judgment is hard enough. Relying on two people’s best judgment gets even more tricky.
If you want assistance drafting a Durable Power of Attorney for Health Care that best meets your needs, contact us for a free consultation at firstname.lastname@example.org or tel. 206-459-1908.