When a patient has no advance directive and cannot communicate, whose preferences guide end-of-life measures?

When a patient has no advance directive and cannot communicate, whose preferences guide end-of-life measures?

• A. Notary and attorney
• B. Physician and nursing staff
• C. Wife and adult children
• D. The patient’s pastor

Answer: (C)

When there is no advance directive and the patient cannot communicate, decisions about end-of-life care are guided by a surrogate decision maker. The spouse is typically the primary surrogate, with adult children and other close relatives acting as backups. This approach honors autonomy by using someone who knows the patient’s values or what they would have wanted to guide medical choices in collaboration with the care team. The physician and nursing staff remain responsible for explaining options and providing care, but they rely on the surrogate to decide. A notary or attorney does not have medical authority unless they are serving in a surrogate role, and a pastor provides spiritual support rather than making medical decisions. Therefore, the spouse and adult children are the person(s) who guide end-of-life measures in this scenario.

When there is no advance directive and the patient cannot communicate, decisions about end-of-life care are guided by a surrogate decision maker. The spouse is typically the primary surrogate, with adult children and other close relatives acting as backups. This approach honors autonomy by using someone who knows the patient’s values or what they would have wanted to guide medical choices in collaboration with the care team. The physician and nursing staff remain responsible for explaining options and providing care, but they rely on the surrogate to decide. A notary or attorney does not have medical authority unless they are serving in a surrogate role, and a pastor provides spiritual support rather than making medical decisions. Therefore, the spouse and adult children are the person(s) who guide end-of-life measures in this scenario.