Making Medical Decisions for Someone Else:
A Guide for Marylanders
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someone close to you is seriously ill and can’t
make health care decisions, a doctor might ask you “What
should we do next?” This could happen if the patient named
you to make medical decisions. It could also happen because you
are a relative or close friend of the patient—or sometimes
because a court gave you the responsibility.
No matter how it came about, you should feel honored to be doing
something so important for the patient. But the task can be hard,
filled with emotion, worry, and doubt.
page tells what to do while there’s still time to
think about it. It also suggests how to make the hard decisions.
And it tells where you can get help and more information.
to Do While There’s Still Time
Sometimes you know ahead of time that you might be making medical
decisions for someone else. This happens when someone has named
you to do this in a legal document called an advance directive.
(Some people call this a durable power of attorney for health care.)
In Maryland, the person named to make decisions in this document
is called a health care agent.
you know you are going to be someone’s health care agent,
the most important thing you can do is talk to that person while
there’s still time. After all, the decisions that you’ll
make should be based on what the other person would want, even
if that is different from what you would want for yourself. So
learn about the other person’s values and beliefs. Don’t
be afraid to use the “D” word: dying. How does the
person want to live during the days or weeks before death?
nobody has named you as a health care agent. Still, you might be
called upon to make medical decisions as what the law calls a surrogate.
Under Maryland law, this is usually a family member, but possibly
a friend, who can make decisions when the patient cannot and when
the patient hasn’t named a health care agent. (One type of
surrogate is a guardian, appointed by a court.)
you think you might become someone’s surrogate, have
a conversation about values, beliefs, and the end of life. Ask
whether the person has any particular wishes about care under certain
conditions. It’s tough to talk about illness and dying, but
it’s a lot tougher making decisions without having a sense
of what the patient would want.
What to Do When the Patient Can No Longer Decide
You have three basic things to do:
find out the medical facts. Ask doctors and nurses what the current
situation is and what’s most likely to happen.
Second, find out the medical choices. Have the doctor explain the
risks and benefits of each choice.
Be prepared to get the most out of your time with the doctor:
a list of questions beforehand.
the doctor about things you don’t understand. But don’t
expect certainty or guarantees.
about bringing a friend or relative of the patient’s
along to help you talk with the doctor—and for
decide as the patient would want. From what the patient wrote
you, you might know for sure. Or you might be pretty
confident because you have a sense of the patient’s values.
If you’re still unsure what the patient would want, then
do what gives the most benefit to the patient with the least burden.
a health care professional might ask you to go over your decisions
and write them on a form for the medical record.
One form used in Maryland, especially in nursing homes, is called
the Patient’s Plan of Care form. The form should clearly
state your decisions.
Where to Get Help
is available if you need it. You don’t have to handle
things by yourself. Talk with family members or the patient’s
spiritual advisor. You can also get information and help from the
professionals in hospitals or nursing homes—like a social
worker, patient representative, or ethics committee.
How to Get More Information
much more detailed version of this guide is in a booklet called
Medical Decisions for Someone Else: A Maryland Handbook.
a printed copy of the booklet, leave your name and address at this
number: (410) 576-7000 or email firstname.lastname@example.org.
guide has been prepared by the American Bar Association
Commission on Law and Aging in collaboration with the
Maryland Office of the Attorney General Douglas F.
Gansler Attorney General
for the printed version of this guide was provided by the
Morton K. and Jane Blaustein Foundation
Copyright © American Bar Association. The ABA hereby grants permission
for this guide to be reproduced in its entirety and without alteration for
non-commercial purposes by not-for-profit organizations and federal, state,
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expressed herein have not been approved by the House of
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Association and, accordingly, should not be construed as
representing the policy of the American Bar Association.