If a patient cannot communicate and has no advance directive, who is responsible for end-of-life decision-making according to the source?

If a patient cannot communicate and has no advance directive, who is responsible for end-of-life decision-making according to the source?

• A. A The patient’s wife
• B. B A notary and attorney
• C. C The primary health care provider
• D. D Such decisions cannot be made if the patient is unable to communicate.

Answer: (D)

When a patient cannot communicate and has no advance directive, end-of-life decisions are made by a legally authorized surrogate decision-maker. This surrogate is identified by state law or institutional policy and is usually a close family member, often the spouse, followed by other adult relatives. The surrogate uses substituted judgment—trying to decide as the patient would—if past wishes are known; if not, they decide in the patient’s best interests. The primary health care provider participates by sharing information and facilitating the process, but does not unilaterally decide. A notary or attorney only has decision-making authority if they have a specific legal appointment, such as a durable power of attorney for health care. If no surrogate can be identified, a court may appoint a guardian to make the decisions.

When a patient cannot communicate and has no advance directive, end-of-life decisions are made by a legally authorized surrogate decision-maker. This surrogate is identified by state law or institutional policy and is usually a close family member, often the spouse, followed by other adult relatives. The surrogate uses substituted judgment—trying to decide as the patient would—if past wishes are known; if not, they decide in the patient’s best interests. The primary health care provider participates by sharing information and facilitating the process, but does not unilaterally decide. A notary or attorney only has decision-making authority if they have a specific legal appointment, such as a durable power of attorney for health care. If no surrogate can be identified, a court may appoint a guardian to make the decisions.