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The Probate and Family Court Department 

Procedure for Actions Filed Under G. L. c. 201D 

What is Required to Commence an Action Under G. L c. 201D? 

  An  action  may  be  commenced  by  filing  a  Petition  for  Special  Proceeding  In 
Re:  A  Health  Care  Proxy  Pursuant  to  G.  L.  c.    201D  (MPC  405)  (hereinafter 
“Petition”) in order to: 

o  Affirm a health care proxy; 
o  Remove a health care agent; 
o  Override a health care agent’s decision; 
o  Determine the validity of the health care proxy. 

  For all other requests, a General Probate Petition (MPC 200) must be filed. 

What Additional Forms are Required? 

  Statement  of  Attending  Physician  Filed  With  Petition 

for  Special 
Proceeding  In  Re:  A  Health  Care  Proxy  (MPC  406)  (hereinafter  “Physician’s 
Statement”). 
 

o  The Physician’s Statement must be filed with the Petition.  
The examination must have taken place no more than 
thirty (30) days prior to the filing of the petition. 

o  The Physician’s Statement contains confidential health 

information. The Physician’s Statement must be 
impounded and not kept in the public file.   

 

 

   

 

 

 

     

 

 

 

 

 

 

 

 

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Where is the Petition Filed? 

  The Petition may be brought in matters where a guardianship is already in place 
(where the Respondent retains the right to make medical decisions), or it may be 
brought independent of any other action.  A dispute regarding a health care proxy 
may also be raised in a pending guardianship without filing a Petition.  See, e.g., 
Guardianship of Elma Mason, 41 Mass.App.Ct., 298, 669 N.E.2d 1081 (1996). 
 

If there is no guardianship, the Petition is to be filed in the 
county where the Principal resides, whether in a home or 
at a nursing facility. 

If the Principal is under a Massachusetts guardianship, the 
Petition is to be filed in the division where the guardianship 
was allowed.   

What is the Filing Fee? 

  The filing fee is $150 plus a $15 surcharge, if applicable.  See the Probate and 

Family Court Uniform Fee Schedule for details regarding a surcharge.   
 

What Happens Next? 

  When the Petition is filed, the court will provide a hearing date.  The hearing date 
must be entered on the Petition in the space provided in order to notify others 
when served.  The process is similar to the process used to schedule and hear a 
motion.   
 

  Most proxy disputes concern time sensitive decisions.  Every attempt should be 
made to schedule the hearing no more than 10 calendar days after the Petition 
is filed. 
 

Is Counsel Appointed for the Principal? 

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If the Principal does not have private counsel at the time of filing the Petition, the 
court must immediately appoint counsel.  Appointments will be made from CPCS 
attorneys associated with Fee Generating Category “A”.  A copy of the Petition 
and all documentation must be provided to appointed counsel.

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What are the Notice Requirements? 

  The Principal must be provided notice of any proceeding commenced under the 
health care proxy statute, absent a court order.  In general, ex-parte relief is not 
available.   
 

  Notice  of  the  Petition  must  be  provided  not  later  than  72  hours  prior  to  the 
hearing, in-hand, to the Principal and to the following interested persons, if any; 

Counsel for the Principal 
Health Care Agent and Alternate Health Care Agent  
Spouse of Principal 
Children of Principal 
Guardian or Conservator of Principal in the Commonwealth or elsewhere 
Holder of Durable Power of Attorney  
Health Care Provider/Physician (depending upon the nature of the dispute) 

 
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If the Principal has counsel notice must be provided in-hand or by facsimile to 
counsel. 
 
If the Principal resides in a facility defined by G. L. c. 201D, § 1, notice must be 
provided in-hand or by facsimile to the facility. 

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How Can an Interested Person Object to a Proceeding? 

  The  Principal  or  persons  interested  in  the  proceeding  may  object  by  filing  an 
appearance for the purpose of objecting prior to the hearing date or by appearing 
at the hearing and objecting on the record.  Form (MPC 505a), Appearance (and 
Objection)  may  be  used.    An  Affidavit  of  Objections  is  not  required.    In  the 
alternative, Form (CJP 126), Notice of Appearance may also be used. 
 

What Happens at the Hearing? 

  At the hearing, the court can order that a health care proxy is valid, or that it is 
invalid;  that  the  health  care  proxy  is  affirmed,  or  that  the  health  care  agent  is 
removed.    The  court  can  also  override  an  agent’s  decision  on  the  ground  that 
such decision was made in bad faith or not in accordance with the statute. The 
court will issue a Decree on Special Proceeding In Re: Health Care Proxy (MPC 
793). 
If the court affirms a health care proxy, the Decree will indicate that a decision to 
affirm  the  health  care  proxy  continues  until  the  Principal’s  attending  physician 
determines  the  Principal  has  regained  capacity  to  make  or  to  communicate 
health care decisions.   

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