How should a physician respond when someone other than a family member is designated as the surrogate decision maker for a patient who lacks decision-making capacity?

• A. Talk to the surrogate to make a decision
• B. Follow the instructions of the family
• C. Mediate between parties
• D. Consult legal affairs to determine the decision-maker

Answer: (A)

When a patient cannot make medical decisions and a legally designated surrogate is in place, the physician should speak directly with that surrogate to determine and honor the patient’s likely wishes. The designated surrogate has the authority to guide decisions on the patient’s behalf, using the patient’s values and previously expressed preferences as a guide. This ensures care aligns with what the patient would have wanted, rather than being driven by the physician’s own views or by family members who lack authority. If questions or conflicts arise, the physician can engage the surrogate to clarify goals and, if needed, involve mediation or legally verify authority, but the primary step is to consult the designated surrogate to proceed with care decisions.