Choosing a Medical Proxy in Mexico
When we think about end-of-life planning, it’s easy to imagine the process as a simple matter of filling out forms. With the assistance of a notario, we complete advance directives, powers of attorney, and a last will and testament. The truth is, those forms are only the beginning.
A medical proxy in particular is far more than a name on a page. It is a human relationship, a series of conversations, and a commitment to honoring the values of those who can no longer speak for themselves.
Choosing the right medical proxy is essential, especially for expats in Mexico, where unfamiliar systems, language barriers, and cultural differences add complexity to being one’s health advocate.
Beyond the Piece of Paper
Legal documents matter. They provide clarity and authority in moments of uncertainty. But most advance directive forms are incredibly general and offer little more than boxes to check: Resuscitate or not? Intubate or not? They rarely capture why we’d opt for a particular treatment or decline it, or what we hope to avoid by doing so. Real life is filled with gray areas.
A form can’t advocate for you the way a human being can. In the critical present moment, it matters little if your advance directive or voluntad anticipada is legally binding. What matters are the decisions made by those who are caring for you. Will they see or read what’s on a piece of paper? If so, will they understand the true intent behind it? Will medical personnel feel empowered to choose as you would have, or will they default to protecting themselves? Your medical decision-maker, the real person who will advocate for you in your moment of need, is far more important than which boxes are checked on any piece of paper. Who will you choose?
Courage and the Qualities of an Effective Medical Proxy
We all know someone who filled out their documents, tucked them away in a drawer, and never told another soul. But forms work best when paired with a real relationship. Your proxy is the one who must speak up when you cannot, often against momentum or authority.
Anyone who has navigated a healthcare system knows this: once curative treatment is in motion, it’s hard to slow it down. It takes courage to question, pause, or redirect the plan, especially in a country where culture, customs, bureaucratic and medical processes may be unfamiliar.
People who default to authority, who avoid confrontation, or who struggle to trust their instincts may not be ready to make life-and-death decisions on your behalf. In addition to courage, the following traits are highly valuable…
Emotional steadiness when under stress
Trustworthiness and integrity
The genuine desire to be of service
You may already have a few names in mind. In Mexico, there are also a few more things to consider.
The Unique Requirements of Medical Proxies in Mexico
Choosing a proxy in Mexico poses unique challenges, especially for expats living far from family or navigating a different language and culture.
When selecting a proxy in Mexico, consider …
Whether your proxy lives in Mexico full-time
How easily they can be reached in an emergency
Their ability to communicate in Spanish
Their understanding of local systems and norms
In stark contrast to best practice in the US, it’s wise to name more than one proxy in Mexico. Some people advise that you choose up to three. Emergencies don’t wait for convenient timing and your top choice may be unreachable or unavailable.
Should My Spouse Be My Proxy?
Many expats rely primarily on their spouse. This can be both beneficial and complicated.
Pro: No one knows you better.
Con: Emotional closeness can make it harder for your spouse to follow your wishes.
Consider age, health, and the reality that you and your spouse may be navigating the end of life at the same time. This is another reason why multiple proxies are helpful.
New to Mexico? Consider This an Invitation
If you’re new to Mexico, you may feel far from trusted friends. Choosing a proxy is an opportunity to:
Get to know your neighbors
Practice your Spanish
Connect across generations
In one sense, dying is a solitary act. We each make that transition alone. The end of life, however, is also deeply communal. The support we build now shapes the care we receive later.
Starting the Conversation
Once you have a few medical proxies in mind, it’s time to start the conversation. This is not a one-and-done, but rather, the start of an ongoing relationship.
Before adding someone’s name to your documents, ask for their consent. It’s possible they will feel honored, but they could also feel overwhelmed.
Proxy roles can require time, emotional labor, and the ability to act in high-stress situations. Starting with a conversation ensures the role is agreed upon, versus assumed.
If someone does express uncertainty, it’s not necessarily a sign that they are a poor choice. Rather, it can be an opportunity for further discussion regarding what a medical proxy is, your needs and your expectations.
An Ongoing Conversation
Once you’ve asked your proxy for permission, meeting them at the notario and adding their name to your documents is not the final step. This process is ongoing, and includes talking with your chosen proxies openly and repeatedly.
If you’re not sure where to start, your conversation might begin with logistics. Do your best, however, to take it further. Be vulnerable, honest, and open. It prepares both you and them, practically and emotionally, for what lies ahead.
You might begin by explaining where to find essential information:
Your doctor’s name and number
Your preferred hospital
Your advance directive and what’s on it
If you are living with a specific illness, help your proxy understand how it progresses. Invite them to a doctor’s appointment. Share what choices you would make as your symptoms change.
Then, move into what truly matters, including the ‘why’ behind your choices.
Why you do or do not want a DNR or DNI
What quality of life means to you
What suffering you hope to avoid
What conditions would make you feel ready to let go
Whether you fear dying in a hospital—or fear not being in one
Who you hope will be by your side
What a peaceful death looks like in your mind
These conversations can be tender and emotional. That’s okay. We prepare for emotional difficulty not by avoiding it, but by facing it together in the present moment.
Studies show that avoiding thoughts of death actually increases anxiety. In contrast, gently exploring mortality:
Increases gratitude
Supports emotional growth
Deepens relationships and community bonds
Clarifies what we value most in life
The more we explore death, the more we understand how we want to live.
When You’re Not Yet Sure What You Want
Many people approach this process unsure of what they want. That’s completely normal.
You may not know:
What you want your final days to look like
Which treatments you would accept
Who you trust enough to be your proxy
Reflection is an ongoing part of the planning process, not a prerequisite.
Your preferences may evolve. Relationships shift. Illness or diagnoses sometimes brings clarity. Life teaches us what matters in its own time.
How much time we have left, however, is an unkown, so begin the process now. Invite someone to come with you on this journey of exploration.
“Have you ever thought about what you would want if…”
“What we went through with my mom was really hard. I’m not sure I’d make the same decisions. What do you think?”
“Do you think there would ever come a time when you’d forgo curative care and just want comfort?”
“What does quality of life mean to you?”
Preparing for the Future for Greater Presence Now
In the end, choosing your proxies and engaging in ongoing conversation with them, isn’t ‘just’ about dying. It’s about living. Talking openly about end of life:
Strengthens our relationships
Deepens trust
Helps our loved ones feel confident in the choices they’ll make
Reduces suffering - for us and for them
Invites us to live with greater intention now
We won’t be here to comfort our medical proxies after we die. We won’t get to say: You did the right thing. Thank you for caring for me the way I asked to be cared for.
But we can say those things now.
We can prepare.
We can talk.
We can let our wishes be known.
We can walk into these conversations with courage and tenderness.
Your proxies, and your future self, will thank you for it.
