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What to do if…
you are asked to make medical decisions for a relative who cannot communicate their wishes

Produced and maintained by PanicStation.org Published: Last reviewed: Editorial policy USA guide

Short answer

Ask the care team to confirm who the hospital recognizes as the authorized surrogate under applicable state law and hospital policy. Request a family meeting so the next decision can be explained clearly and guided by your relative’s known wishes and values.

Do not do these things

  • Do not agree to a decision just to stop the pressure. Ask which decision is needed now and whether a brief pause for explanation is medically safe.
  • Do not assume that being the nearest relative automatically makes you the authorized decision-maker. Ask the hospital to confirm.
  • Do not make promises to other family members before the care team has explained the medical options.
  • Do not argue at the bedside or during an unplanned speakerphone call. Ask staff to arrange one structured conversation.
  • Do not treat a DNR order as meaning “no care.” A DNR order is about CPR if the heart or breathing stops; it does not by itself rule out other treatment or comfort care.

What to do now

  1. Ask whether your relative can take part in the decision and what must happen now.
    Ask: “Can my relative make or help with this decision right now?” and “Which decision is needed now?” Ask whether a brief pause for explanation or a family call is medically safe.

  2. Ask the team to check for existing documents and orders.
    Ask whether the hospital has:

    • An advance directive or living will
    • A durable power of attorney for health care or health care proxy
    • A POLST, MOLST, POST, or another state-specific portable medical orders form
    • A DNR order
      Ask whether staff can also check available prior records and review any document brought in by family.

  3. Ask the hospital to confirm the authorized surrogate.
    Say: “Please confirm who the hospital recognizes as the authorized surrogate under the applicable state law and hospital policy.” If several relatives appear to have equal priority, ask how the hospital handles disagreement.

  4. Request one structured meeting or scheduled call.
    Ask for the attending clinician, bedside nurse, and palliative-care team if available. Ask for one scheduled call if family members cannot attend in person. Take brief notes about the next decision, the options, and the agreed plan.

  5. Share your relative’s known wishes and values.
    Tell the team about any statements your relative made about CPR, life support, ventilators, feeding tubes, comfort-focused care, or outcomes they would personally find unacceptable. Ask staff to record this information in the medical record. If their preferences cannot reasonably be inferred, ask the team to explain how the decision should be approached using their best interests.

  6. Ask for a plain-language comparison of the immediate options.
    Ask:

    • What treatment is being proposed now?
    • What is the likely benefit?
    • What burdens or discomforts may come with it?
    • What may happen if it is not used?
    • What would comfort-focused care involve right now?

  7. Ask for help if there is unresolved uncertainty or conflict.
    Ask whether an ethics consultation or another hospital ethics resource is available. Ask whether a social worker, care coordinator, or patient advocate is available if communication is becoming difficult.

  8. Ask whether palliative care or a hospice evaluation is appropriate.
    Palliative care may be relevant alongside other treatment. Ask whether a hospice evaluation is appropriate for your relative’s situation.

What can wait

  • You do not need to settle every family disagreement today.
  • You do not need to decide financial matters or funeral arrangements during the immediate medical conversation.
  • You do not need to answer every call or message. Ask one person to update others.
  • You do not need to decide everything at once. Focus on the next decision that the care team says is needed.

Important reassurance

You are not expected to decide what is medically appropriate on your own. Your role is to help the care team understand your relative’s wishes, values, and priorities as clearly as possible. Feeling overwhelmed, uncertain, or upset does not mean you are failing.

Scope note

These are first steps for the immediate situation. Later decisions may need specialist help. If authority or treatment decisions remain disputed, the hospital may use additional clinical, ethics, or legal review and, in some cases, a court process.

Important note

This guide is general information, not legal, medical, financial, therapeutic, or other professional advice. Surrogate decision-making rules vary by state and may depend on the situation. Ask the care team to confirm who is authorized to decide and to record the decision-maker and immediate plan in the medical record.

Additional Resources

Closely connected guides that may be useful during the same situation or its immediate aftermath.

About this guide

This guide was produced and is maintained by PanicStation.org using its published editorial process. Official and specialist sources are checked where relevant, and AI-assisted tools may be used for drafting, organisation, and consistency checks. The site operator remains responsible for publication, revision, and removal decisions.

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