Next-of-kin surrogate decision maker

Patient selection

• Inability to communicate wishes regarding medical decision-making
• Advance directive not available or applicable
• No previously designated surrogate decision maker

Surrogate selection

• Priority to patient's spouse
• Alternate: adult children, parents, adult siblings, other family members

Implementation

• Substituted judgment: what the patient, not family, would have wanted
• Decisions in the patient's best interest