Making Medical Decisions for Someone Else: Guidance for Health Care Agents, Medical Guardians, and Surrogates (2024)

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.

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.