Coronavirus Update: Ethics Considerations, Guidance and Resources.
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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.

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