Questions & Answers: Advance Directives and End of Life Decisions
Who would make decisions about my medical care if I did not complete advance directives?
There is no simple answer to this question. In general, physicians consult
with families when the patient cannot make decisions. But if the decision
involves ending a treatment and will result in the person's death, the family
may or may not be permitted to make the decision, depending on state law.
In some states treatment cannot be withheld or withdrawn without clear and
convincing evidence that the person would refuse it. In other states, if the
physician and the family agree, the treatment could be stopped without recourse
to any outside authority (such as the courts). If any conflict about treatment
exists among family members or between the family and the physician, treatment
is likely to continue until the patient dies or the issue is resolved through
A number of states have passed surrogate decision-making statutes. These
laws create a decision-making process by identifying the individuals who may
make decisions for patients who have no advance directives. However, the person
whom the law appoints to make decisions might not be the person you would want
as your decision maker or might make decisions you would not want. Thus, it is
important to name the person you do want by completing advance directives,
including the appointment of an agent.