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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In some states treatment cannot be withheld or withdrawn without clear and convincing evidence that the person would refuse it.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 legal action.

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.