When does the authority of a health care proxy commence?

• A. Immediately upon execution by the principal
• B. Upon a determination that the principal lacks capacity
• C. Only after a physician signs off on incapacity
• D. Upon the principal's death

Answer: (B)

In New York, a health care proxy’s authority starts only when the principal lacks decision-making capacity, as determined by a physician. The proxy cannot act while the principal still has capacity to understand and decide about health care. Once a physician certifies incapacity, the proxy steps in to make health care decisions in line with the principal’s wishes or instructions. The authority ends if the principal regains capacity or dies.