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.