A power of attorney (POA) is a signed legal document that gives one person (the agent or attorney-in-fact) the power to act for another person (the principal). The power of attorney may grant the agent broad legal authority to make decisions and create binding agreements or obligations for the principal regarding the principal’s property, finances, or health care—or may only grant the agent or attorney-in-fact limited authority in the scope, nature, or amount of these decisions (a limited or special power of attorney).

There are different types of powers of attorney, and the powers and names of these grants of legal authority vary from state to state.

A traditional power of attorney (general or limited) usually lapses or ends when the principal who granted the power to the agent or attorney-in-fact becomes incapacitated—whether due to physical or mental disability or incapacity. But a durable power of attorney (DPOA) survives the physical or mental incapacity of the principal. And a springing power of attorney comes into effect only if and when the principal becomes physically or mentally incapacitated.

For example, a durable power of attorney for health care—also known as a medical power of attorney—is a legal document that a person (the principal, grantor, or donor) signs to appoint another person as the principal’s agent, attorney-in-fact, health care surrogate, or health care proxy—with authority to make health care decisions for the principal if the principal becomes physically or mentally disabled or incapacitated (incompetent) from a stroke, Alzheimer’s disease, automobile accident, or other cause.

A person appointed as agent or attorney-in-fact for health care decisions will be able to accept or refuse medical treatment for the principal, access the principal’s medical records, and in the event of the principal’s death, authorize an autopsy, donate the principal’s organs, and dispose of the principal’s body by burial or cremation.

But an agent or attorney-in-fact for health care decisions has no ability to make these decisions for the principal until the principal becomes physically or mentally disabled or incapacitated (incompetent)—unless the document provides otherwise.

A principal generally has the ability to revoke or change a durable power of attorney for health care or Advance Health Care Directive at any time before becoming incapacitated. And a principal can limit the scope of the durable power of attorney for health care or Advance Health Care Directive to limit the agent's or attorney-in-fact’s powers and ability to make certain health care decisions.

In addition to these limitations, some states prohibit certain health care decisions from being made by an agent or attorney-in-fact—such as euthanasia, psychosurgery, sterilization, abortion, convulsive treatment, or placement in a mental health treatment facility.

Laws and terminology for documents related to health care decisions vary from state to state. These laws are generally located in a state’s statutes—often in the probate code or estates code.

In Maryland, a Power of Attorney (POA) is a legal document that allows an individual (the principal) to appoint another person (the agent or attorney-in-fact) to make decisions on their behalf. The scope of this authority can be broad or limited, and the POA can be categorized as general, limited, or durable. A Durable Power of Attorney (DPOA) remains effective even if the principal becomes incapacitated. Maryland recognizes a specific form of DPOA for health care decisions, often referred to as an Advance Directive, which enables the appointed agent to make health care decisions for the principal if they are unable to do so themselves due to incapacity. The agent's powers can include making treatment decisions, accessing medical records, and handling matters after the principal's death, such as organ donation and burial arrangements. However, the agent's authority is activated only upon the principal's incapacitation unless the POA document states otherwise. The principal retains the right to revoke or amend the POA or Advance Directive at any time before incapacitation. Maryland law may restrict certain decisions from being made by the agent, in line with ethical and legal standards. It is important for individuals to comply with Maryland's specific requirements for creating a valid POA to ensure that it is legally enforceable.