Surrogate Decision-Making

Any person authorized (by statute or by common law) to make decisions on behalf of another person is a surrogate. The surrogate gives or refuses vicarious consent to treatment options recommended by the patient’s physician. In state statutes concerning Durable Power of Attorney for Healthcare, the appointed surrogate is variously referred to as the patient advocate, patient proxy, patient representative, or attorney-in-fact. If the patient’s wishes are known, the surrogate should use substituted judgment, for which some states may require clear and convincing evidence of the patient’s prior wishes. If the patient’s wishes are unknown, the surrogate should act in the patient’s best interests for determining the appropriate course of action. (See also Ethical and Religious Directives, nn. 25 and 26.)

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