Making Medical Decisions for Someone Else

There may be times when you are called upon to make medical decisions for someone else. When you are making decisions for a person who is not able to make decisions for themselves, you are acting as a surrogate decision-maker.

Types Of Surrogate Decision-Makers

Health Care Agent – a special kind of surrogate that an individual names in an advance directive before they lose the ability to make decisions for themselves. Prior to 2005, this was called a Durable Power of Attorney for Health Care.
Medical Guardian – a special kind of surrogate that arises when a court issues an order authorizing someone to serve as guardian with medical decision-making powers for another person.
Surrogate – if a person has not named a health care agent in an advance directive and a court has not appointed a guardian with medical decision-making authority, family members, close friends, or someone with a known close relationship to the patient are frequently called upon to make medical decisions when a person cannot speak for themselves.

The scope of authority for each type of decision maker varies, particularly for end-of-life and/or DNR/COLST decisions. To learn more, read Making Medical Decisions for Someone Else: a Vermont Handbook.

		Responsibilities of Surrogate Decision-Makers
To make decisions consistent with what the person would decide if they were able.  If you don’t know what they would choose, make the decision that is in their best interest.
To ask questions of the medical team and get the explanations you need so that you can understand the person’s medical condition and all possible treatment options.
To consent to or refuse medical tests or treatment based on your knowledge of the person’s goals and priorities, if known, or based on what is in their best interest.
To communicate with the person as much as possible and support them in participating in as much of the decision-making as their capacity allows.


	

Preparing Ahead of Time

Find out what matters most to the person if they were to become seriously ill
Have conversations about their values and priorities before a health crisis arises
Learn about their hopes and fears for the future
Talk about what they would be willing to sacrifice for a chance at getting better or living longer
Find out if there is anything they would not be willing to do—even it if means they might die

These can be difficult conversations but it is a lot harder to make medical decisions for someone else if you do not have a sense of what it most important to them.

Making Medical Decisions for Someone Else Handbook

Making Medical Decisions for Someone Else: a Vermont Handbook

Living Voice: Are You a Healthcare Proxy?

Your Guide to Being a Health Care Agent

Print copies are also available by contacting the Vermont Ethics Network.