What is the role of a healthcare surrogate/proxy in advance directives?

• A. They are the patient's attorney for financial affairs.
• B. They are the hospital administrator on duty.
• C. They are the person designated to make healthcare decisions for the patient when they cannot.
• D. They are the physician assigned to the case.

Answer: (C)

The main idea is that a healthcare surrogate or proxy is the person chosen to make medical decisions for a patient when the patient cannot express their wishes. This role is typically established through an advance directive or a durable power of attorney for healthcare. The surrogate’s job is to act in accord with what is known about the patient’s values, beliefs, and any previously stated preferences. When those specifics aren’t known, they should decide in the patient’s best interests, prioritizing what would be most aligned with the patient’s overall welfare.

In practice, the surrogate can consent to or refuse medical treatments, including end-of-life care, and their authority is limited to the scope defined by the directive and by applicable law. They should stay closely connected with the medical team, seek clarifications, and ensure decisions reflect the patient’s wishes as much as possible. They aren’t responsible for financial matters (that would be a financial power of attorney), they aren’t hospital administrators, and they aren’t the physician treating the patient. Their power to make decisions lasts only while the patient lacks decision-making capacity and ends if capacity returns or after the patient’s death.