Default Health-Care Surrogate Priority by State
When an adult cannot make a health-care decision and no appointed agent is available, who may decide under state law, in what order, and with what limits?
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Statutes checked
Every entry, oldest check October 8, 2026
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What this survey covers
When an adult cannot make a health-care decision, state statutes may identify another person who can decide without a new appointment document. The table follows the statutory order and the rules for choosing among people in the same class. An existing agent or guardian may take precedence.
Why the columns differ
Florida § 765.401 puts an authorized guardian first and then ranks a spouse, adult children, parents, siblings, a qualifying relative, a close friend, and a selected clinical social worker. It calls for a majority of reasonably available adult children or siblings when either class has more than one person.
Texas Health and Safety Code §§ 313.003–.004 uses a narrower setting list: specified home-care services, hospitals, nursing homes, and county or municipal jails. Its family ladder starts with the spouse, adult children, parents, and nearest living relative. It gives a separate uninvolved-physician route if nobody in the listed classes is reasonably available and excludes decisions to withhold life-sustaining care from this chapter.
Washington RCW 7.70.065 includes a domestic partner, several degrees of extended family, and a qualified close friend with a signed declaration. For adults, the statute requires unanimity among available people in the same class before they authorize care.
Vermont 18 V.S.A. §§ 9710 and 9731 has no ranked family ladder for general care in these provisions. An interested individual may consent to a DNR/COLST order after the patient or interested people select that person, while a family member or close person may separately elect hospice care when an agent or guardian cannot act.
Wyoming § 35-22-406 lets the patient personally designate a surrogate and calls its fallback family order suggested. Its operative same-class disagreement rule follows the majority of class members who communicated their views to the provider. The District § 21-2210 requires a witness for a decision by the listed noncourt representatives and permits a listed person to challenge a higher-priority decision in court.
Scope boundaries
This table compares statutory authority and its limits. It does not decide whether a particular patient has capacity, identify the available relative on disputed evidence, or substitute for a treatment or court decision.
State by state
Every column answered the same way for each jurisdiction. Open a state for the full page, with the statute text and the date it was checked.
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| State | When the default route opens | Care or setting covered | Guardian or appointed agent | Family and partner order | Friend or other nonfamily person | Decision within one class | Who is available and eligible | Decisions limited or excluded | No surrogate or disputed authority |
|---|---|---|---|---|---|---|---|---|---|
| Alabama verified 2026-10-08 | No adequate directive or available appointed proxy; attending physician finds lasting inability to decide, and two physicians certify terminal illness/injury or permanent unconsciousness (§ 22-8A-11(a)). |
Surrogate ladder covers only life-sustaining treatment and artificially provided nutrition or hydration, in consultation with the attending physician (§§ 22-8A-3(10), 22-8A-11(a)). |
Judicial guardian only if specifically authorized for these decisions; otherwise available appointed health-care proxy precedes default surrogate (§ 22-8A-11(a), (d)(1)). |
Eligible spouse; one adult child; one parent; one adult sibling; then one surviving adult relative in the next closest kinship degree (§ 22-8A-11(d)(2)–(6)). |
If no relatives are known or found after reasonable inquiry, a unanimous treating-physician/ethics-committee or specified substitute committee may decide (§ 22-8A-11(d)(7)). |
One eligible relative may serve, but surrogate must certify contacted equal- and higher-class people consented or did not object; specified unreachable people are excluded (§ 22-8A-11(d)–(f)). |
Competent adult; prior classes unavailable or unwilling. Surrogate certification is signed before two witnesses age 19+ (§ 22-8A-11(b), (d), (i)). |
Patient’s known values guide decision; artificial nutrition/hydration withdrawal for permanent unconsciousness needs clear-and-convincing evidence of desires (§ 22-8A-11(c)). |
A qualified unanimous facility committee may act when relatives cannot be found; circuit court may hear challenges or competing authority claims (§ 22-8A-11(d)(7), (j)). |
| Alaska verified 2026-10-08 | Primary physician finds adult lacks capacity; no appointed agent/guardian or neither reasonably available; emergency mental-health route has added finding (§§ 13.52.030(a)–(b), 13.52.100). |
General health-care decisions; emergency mental-health decisions only under special clinician finding; life-sustaining withdrawal has qualifying-condition rule (§§ 13.52.030(a)–(b), 13.52.045). |
Available agent or guardian precedes default surrogate; agent decision prevails over guardian unless court orders otherwise (§§ 13.52.030(a), 13.52.040(b)). |
Patient’s oral designee; then spouse not legally separated, adult child, parent, adult sibling (§ 13.52.030(c)). |
Patient may name any individual orally; if no listed person available, a concerned adult familiar with patient’s values may act (§ 13.52.030(c)–(d)). |
Informed disagreement among same-rank children/parents/siblings: communicated-view majority; even split disqualifies lower classes and physician decides after consultation (§ 13.52.030(f)). |
Reasonably available designee/family/friend; patient may disqualify person; unrelated facility owner/operator/employee barred; provider may demand sworn declaration (§ 13.52.030(c)–(d), (j)–(l)). |
Mental-health decisions require emergency and two-clinician finding; qualifying-condition rule for life-sustaining withdrawal; exceptional-procedure and pregnancy limits (§§ 13.52.030(b), 13.52.045, 13.52.050, 13.52.055). |
Physician decides after even same-class split and consultation; superior court may direct decision or grant equitable relief (§§ 13.52.030(f), 13.52.140). |
| Arizona verified 2026-10-08 | Adult unable to make or communicate treatment decisions; provider seeks directive and applicable agent or treatment guardian first (§ 36-3231(A)). |
Health-care treatment decisions generally; special limits for inpatient psychiatric admission (§ 36-3231(A), (D)–(E)). |
Designated health-care agent acts, unless a guardian was appointed expressly for treatment decisions (§ 36-3231(A)). |
Spouse unless legally separated; adult children; parent; domestic partner only if patient unmarried; brother or sister (§ 36-3231(A)(1)–(5)). |
Close friend last: adult with special care, knowledge of patient's views, and willingness and ability to act in patient's best interest (§ 36-3231(A)(6)). |
More than one adult child: seek majority consent of those reasonably available; no sibling majority stated in this section (§ 36-3231(A)(2), (5)). |
Provider makes reasonable efforts to contact available, willing people in order; close friend must satisfy statutory relationship tests (§ 36-3231(A)). |
Default surrogate generally cannot admit patient to licensed inpatient psychiatric facility; urgent exception requires court petition within 48 hours or next court day (§ 36-3231(D)–(E)). |
If no listed person can be located, attending physician consults institutional ethics committee, or a concurring second physician if committee route impossible (§ 36-3231(B)). |
| Arkansas verified 2026-10-08 | Adult or emancipated minor lacks capacity as determined by designated physician; an agent or guardian is unappointed or unavailable; provider selection also requires no available patient-designated surrogate (§ 20-6-105(b)–(c)). |
Health-care decisions mean consent, refusal, or withdrawal of consent to care affecting physical or mental condition; provider records the appointment in the clinical record (§§ 20-6-102(7)–(8), 20-6-105(c)(1)). |
Patient-designated surrogate may act if agent or guardian has not been appointed or is unavailable; provider selection follows when none of those people can act (§ 20-6-105(a)–(c)). |
Provider may consider, in descending preference, spouse unless legally separated, adult child, parent, adult sibling, then other adult relative; this is a discretionary consideration, not an automatic appointment (§ 20-6-105(c)(3)–(4)). |
An adult need not be a relative if specially caring, familiar with patient's values, available, and willing; provider chooses the best-qualified surrogate (§ 20-6-105(c)(2)–(4)). |
Provider selects the best-qualified person using individual factors; § 20-6-105(c)(3)–(4) states no majority or unanimity vote among same-rank relatives. |
Adult must show special care and concern, know patient's values, be reasonably available and willing; protective-order subjects are ineligible. Contact, care, visits, and decision ability inform provider selection (§§ 20-6-102(20), 20-6-105(c)(2)–(3)). |
Surrogate follows known instructions and wishes, otherwise best interest. A provider-selected surrogate needs two physician certifications before withholding or withdrawing artificial nutrition or hydration (§ 20-6-106(a)–(b)). |
If no eligible surrogate is reasonably available, designated physician may decide after ethics-officer recommendations or concurrence of an independent second physician. A challenge faces a rebuttable presumption favoring selection (§ 20-6-105(c)(5)–(6)). |
| California verified 2026-10-08 | Patient lacks decision capacity and has no recognized surrogate, agent, or authorized conservator/guardian (§§ 4657, 4712(a)–(b)). |
Adult health-care decisions, including physical/mental care and care-provider selection (§§ 4651(a), 4617, 4712(b)). |
Patient-designated surrogate → agent → authorized conservator/guardian before provider selection (§§ 4711, 4712(a)). |
Provider may choose spouse/partner, adult child, parent, sibling, grandchild, or other adult relative; list is unranked (§ 4712(b)). |
Provider may also choose a close personal friend who meets the care, values, availability, and willingness tests (§ 4712(b)). |
Provider/facility designee selects a qualifying adult appropriate to the situation (§ 4712(b)). |
Adult with special care, familiarity with values, reasonable availability, and willingness; patient may disqualify (§§ 4635, 4712(b), 4715). |
Follow patient instructions/wishes or best interests; no consent to § 4652 treatments (§§ 4617(b), 4652, 4714). |
Provider selection if no recognized decisionmaker; authorized petitioner may ask superior court to review surrogate acts (§§ 4712(b), 4765–66). |
| Colorado verified 2026-10-08 | Adult lacks capacity for informed treatment consent/refusal; no guardian, appointed agent, designated-beneficiary proxy, or other authorized person (§ 15-18.5-103(1)–(2)). |
Medical treatment decisions by a proxy; health-care provider or facility may rely on properly selected proxy (§ 15-18.5-103(1)). |
Existing medical-decision guardian, medical durable-POA agent, designated-beneficiary proxy, or other legal authority takes precedence over this selection process (§ 15-18.5-103(1)). |
No ranked family classes: spouse, parent, adult child, sibling, grandchild, and close friend are interested persons who seek consensus (§ 15-18.5-103(1.5), (4)(a)). |
Close friend may join selection; if none of the interested persons is found or willing, a different willing physician may be designated with safeguards (§ 15-18.5-103(1.5), (4)(c)). |
Interested persons seek consensus on the individual closest to the patient and best informed about wishes; disagreement allows guardianship petition (§ 15-18.5-103(4)(a)). |
Reasonable efforts to notify patient and locate as many interested persons as practicable; attending physician cannot be the proxy (§ 15-18.5-103(1.5)(b), (3)). |
Special two-physician certification for withdrawing artificial nourishment/hydration; physician-proxy written-consent and end-of-life safeguards (§ 15-18.5-103(4)(c)(V), (6)). |
Interested persons may petition for guardianship if selection or a decision is disputed; no willing or reachable interested person permits an independently checked physician proxy with ethics-committee consensus (§ 15-18.5-103(4)). |
| Connecticut verified 2026-10-08 | For life-support withdrawal, patient is incapacitated and terminal or permanently unconscious; clinician must consider wishes (§ 19a-571(a)). Conservator route requires court appointment (§§ 45a-650(f), 45a-656(a)). |
§ 19a-571(a) governs life-support decisions by attending clinician or licensed facility; court-assigned conservator authority can cover medical or other professional care (§ 45a-656(a)). |
An operative appointed health-care representative's decision generally precedes a conservator's, subject to § 19a-580e(b)'s exceptions (§§ 19a-580e(b), 45a-650(j)). |
Spouse, adult child, parent, adult sibling, grandparent are 'next of kin' for consultation about life-support wishes; § 19a-571(a) gives them no family voting ladder (§§ 19a-570(10), 19a-571(a)). |
Clinician may consult others to whom patient communicated wishes; court may assign medical-consent authority to a qualified conservator (§§ 19a-571(a), 45a-650(h), 45a-656(a)). |
§ 19a-571(a) directs clinician consultation, not a same-class family vote; a conservator acts within individually assigned court powers (§§ 19a-571(a), 45a-650(m)). |
Consult representative, next of kin, guardian, conservator and other known speakers if available; clinician makes reasonable effort to notify listed people before life-support removal (§§ 19a-571(a), 19a-580). |
Life-support withdrawal requires best medical judgment, qualifying condition, and consideration of wishes; beneficial treatment continues without terminal or permanent-unconscious finding (§ 19a-571(a)). |
Probate Court hears disputes over advance-directive provisions and representative capacity; court may appoint a conservator with limited medical-consent authority (§§ 19a-580c, 45a-650(f), 45a-656(a)). |
| Delaware verified 2026-10-08 | Adult/emancipated minor lacks health-care decision capacity; no appointed agent or authorized guardian, or none reasonably available (§§ 2502(16), 2504, 2512(a)). |
Physical and mental health care, including providers, diagnostic tests, surgery, medication, nutrition and ventilation; no single-facility limit (§ 2502(11)–(12)). |
Available appointed agent or authorized guardian precedes default surrogate; agent decision prevails over guardian absent contrary court order (§§ 2512(a), 2522(b)). |
Previously identified adult; spouse/domestic partner; adult child or parent together; cohabitant; adult sibling; adult grandchild or grandparent; later care-based classes (§ 2512(b)). |
Previously identified adult; recent routine supported-decision helper; qualifying actively parented stepchild; adult with special care and knowledge of values (§ 2512(b)(1), (7)–(9)). |
Highest-priority class majority of communicated views; solicit reachable silent members on tie; persistent tie goes to other Delaware law (§ 2513(b)–(d)). |
Reachable without undue effort and willing/able timely; patient disqualification and institutional conflicts apply; provider may demand perjury declaration (§§ 2502(24), 2512(b)–(d), 2514). |
Known wishes/best interests govern; mental-health admission needs express directive and lasts at most 72 hours; nursing-home and existing life-support limits (§§ 2517, 2518(e)–(g), 2519). |
Persistent class tie follows other state law; provider may move down if surrogate cannot timely perform duty; decision otherwise needs no court approval (§§ 2512(d)–(e), 2513(d)). |
| District of Columbia verified 2026-10-08 | No health-care power of attorney; incapacity certified in writing by physician plus qualified psychologist or psychiatrist after timely examination (§§ 21-2204, 21-2210(a)). |
Consent, refusal or withdrawal for any health-care service, treatment or procedure; no single-facility limit in this section (§ 21-2210(a)). |
Court-appointed guardian or conservator within appointment scope; then court-appointed intellectual-disability advocate within scope (§ 21-2210(a)(1)–(1A)). |
Spouse or domestic partner; adult child; parent; adult sibling; qualified religious superior; close friend; nearest living relative (§ 21-2210(a)(2)–(6)). |
Religious superior for member of an order or diocesan priest; close friend with significant care, regular contact and familiarity; treating-provider interests disqualify friend (§§ 21-2202(1A), 21-2210(a)(5A)–(5B), (g)). |
Listed classes have priority; § 21-2210 sets no same-class voting formula, but listed persons may challenge a higher-priority decision in Superior Court (§ 21-2210(a), (e)). |
Next class only when prior class lacks a reasonably available, mentally capable and willing person; one witness for consent by persons in (a)(2)–(6) (§ 21-2210(c)–(d)). |
Follow known wishes or good-faith best interests; court order needed for abortion, sterilization, psychosurgery, convulsive therapy or aversive behavior programs (§§ 21-2210(b), 21-2211). |
Provider or interested person may petition Superior Court for guardian if nobody can act; priority presumption may be rebutted for better knowledge of wishes or interests (§ 21-2210(e)–(h)). |
| Florida verified 2026-10-08 | Incapacity or specified developmental disability; no directive/designated surrogate or unavailable surrogate (§ 765.401(1)). |
Health-care decisions, including treatment consent/refusal and mental-health care (§§ 765.101(6), 765.401(1)). |
Already appointed, treatment-authorized guardian first; appointment is not a prerequisite (§ 765.401(1)(a)). |
Spouse → adult child(ren) → parent → adult sibling(s) → qualifying adult relative (§ 765.401(1)(b)–(f)). |
Close friend; then committee-selected, nonemployee clinical social worker (§§ 765.101(3), 765.401(1)(g)–(h)). |
Majority of reasonably available adult children or siblings when more than one (§ 765.401(1)(c),(e)). |
Earlier class must be unavailable, unwilling, or incompetent; availability accounts for urgent care (§§ 765.101(20), 765.401(1)). |
Court approval for listed restricted care absent written delegation; withdrawal has special proof and condition tests (§§ 765.113, 765.401(3), 765.305(2)). |
Committee selects final-tier social worker; interested person may seek expedited judicial review (§§ 765.401(1)(h), 765.105(1)). |
| Georgia verified 2026-10-08 | Personally examining physician records inability to understand/make or communicate significant treatment decisions (§ 31-9-2(c)). |
Lawful surgical or medical treatment/procedures suggested or directed by a licensed physician (§ 31-9-2(a)). |
Authorized advance-directive/health-POA agent before spouse; guardian may consent for ward; family fallback follows (§ 31-9-2(a)(1.1),(2),(4),(6)). |
Spouse; then adult child → parent → adult sibling → grandparent → adult grandchild → specified adult niece/nephew/aunt/uncle (§ 31-9-2(a)). |
Adult friend after listed classes; signed, dated facility acknowledgment of care, familiarity, willingness, and best-interest role (§ 31-9-2(a)(7)). |
“Any one” authorized person may consent; § 31-9-2(a)(6) lists ranks but states no class vote. |
Agent and spouse must be absent or unavailable before lower routes; physician documents inability; reasonable inquiry precedes guardian petition (§ 31-9-2(a),(a.1),(c)). |
Consent only to lawful physician-suggested treatment; act in good faith as patient would want; temporary guardian needs court authority to withdraw life support (§§ 31-9-2(a)–(b), 29-4-18(i)). |
If no authorized person after reasonable inquiry, facility or interested person may seek expedited temporary medical consent guardian (§§ 31-9-2(a.1), 29-4-18(b)). |
| Hawaii verified 2026-10-08 | Primary physician finds adult or emancipated minor lacks capacity; no agent or guardian appointed or reasonably available. Capable patient may personally designate or disqualify a surrogate (§§ 327E-5(a)–(b), 327E-11). |
Physical and mental health care, including providers, institutions, tests, treatment, DNR, and nutrition; no general facility limit (§ 327E-2). |
Available agent or guardian precedes the surrogate. A chapter 560 guardian’s decision prevails over an agent’s absent contrary court order (§§ 327E-5(b), 327E-6(b)). |
No fixed spouse-to-child order: interested persons include unseparated/un-estranged spouse, reciprocal beneficiary, adult child, either parent, adult sibling or grandchild (§§ 327E-2, 327E-5(c)–(d)). |
Interested persons also include an adult showing special care and concern who knows the patient’s values; patient may personally designate any individual (§§ 327E-2, 327E-5(a)). |
Interested persons try to reach consensus on one surrogate based on closeness and knowledge of wishes; disagreement allows a qualified participant to seek guardianship (§ 327E-5(d)). |
Primary physician or designee reasonably seeks as many interested persons as practicable; reasonably available means contactable with diligence suited to urgency and willing and able to act timely (§§ 327E-2, 327E-5(b)–(c)). |
Undesignated surrogate follows wishes or best interest. Artificial nutrition or hydration may be withdrawn only with two-physician record certification; life-sustaining decisions cannot rest on long-term disability or economic status. Psychiatric-facility admission requires express written directive (§§ 327E-5(g), 327E-13(e)). |
Interested participant may initiate guardianship when selection or decision is disputed; court may direct or enjoin a health-care decision on qualifying petition (§§ 327E-5(d), 327E-14). |
| Idaho verified 2026-10-08 | Patient is then unable to consent under the chapter; surrogate must comprehend the care decision. An authorized guardian or agent leads the statutory order (§§ 39-4503, 39-4504(1)). |
Hospital, medical, dental, surgical, and other health services; chapter preserves separate mental-health/developmental-disability hospitalization law and specified reproductive provisions (§ 39-4501(1)–(2)). |
Court-appointed guardian first, health-care agent named in an effective advance care planning document second; spouse follows (§ 39-4504(1)(a)–(c)). |
Spouse; adult child; parent; parental-delegation designee; then any relative, in that order (§ 39-4504(1)(c)–(g)). |
After relatives, any other competent person representing themselves as responsible for the patient’s health care may consent or refuse (§ 39-4504(1)(h)). |
Section 39-4504 gives an ordered list, but leaves selection among several adult children or other equally ranked relatives unstated (§ 39-4504(1)(d), (g)). |
Surrogate must comprehend the need, nature, and significant risks of care; agent’s document conditions must be satisfied. Section 39-4504 does not state a search or contact test (§§ 39-4503, 39-4504(1)). |
Surrogate cannot contradict the patient’s advance planning document or capable wishes. Section 39-4514 protects directed feeding, nutrition/hydration, sustaining and comfort care, and presumes CPR consent subject to its listed exceptions. |
For emergency or serious danger from delay when patient cannot communicate wishes, attending provider may authorize or provide appropriate care. Attending practitioner is responsible for sufficient consent (§§ 39-4504(1)(i), 39-4508). |
| Illinois verified 2026-10-08 | Attending physician records lack of decisional capacity; provider inquires for agent before surrogate (§§ 20(c), 25(a)). |
Patient under licensed physician/provider care, including hospital or other facility; Act also covers no-qualifying-condition decisions (§§ 10, 15, 20(b-5)). |
Authorized available health care agent first; guardian of person heads surrogate list (§§ 15, 25(a)(1)). |
Spouse → adult child → parent → adult sibling → adult grandchild (§ 25(a)(2)–(6)). |
Close friend with familiarity affidavit; later guardian of estate and authorized temporary custodian (§§ 10, 25(a)(7)–(9)). |
Seek consensus; on reported disagreement, majority of available class controls unless minority starts guardianship proceeding (§ 25(a)). |
Adult with capacity, willing and available; reasonable inquiry includes 24-hour family/agent phone attempt when identified (§§ 10, 25(a)). |
Life-sustaining withdrawal requires qualifying condition, concurring capacity/condition findings, and witnessed expression; patient objection stops non-guardian route (§§ 10, 20(b)–(e)). |
Higher-rank person may replace; challenge via guardianship; without surrogate, court-appointed guardian route (§§ 20(b)(2), 20(b-5)(2), 25(c)–(d)). |
| Indiana verified 2026-10-08 | Adult cannot consent; no effective advance directive or designated representative willing, able, and reasonably available (§§ 16-36-1-4, 16-36-7-42(b)). |
Health-care decisions include consent, refusal, withdrawal, life-prolonging procedures, and mental-health treatment unless an advance directive states otherwise; no facility-only limit in the proxy provision (§ 16-36-7-10(1)). |
Available designated representative acts before the default proxy route; a judicial guardian or court-appointed representative leads that route (§ 16-36-7-42(b)–(c)(1)). |
Guardian or court appointee; spouse; adult child; parent; adult sibling; grandparent; adult grandchild; nearest other adult relative (§ 16-36-7-42(c)(1)–(8)). |
After eligible relatives, an adult friend with regular contact and knowledge of activities, health, and beliefs; then religious superior for a member of a religious order (§ 16-36-7-42(c)(9)–(10)). |
Same-rank people reasonably try consensus; if they disagree, a majority of available people at that rank controls (§ 16-36-7-42(f)). |
Prior class must lack someone reasonably available, willing, and competent; provider makes reasonable inquiry including records and effects and attempts high-priority contacts; listed court-order, criminal-charge, and spouse disqualifications apply (§§ 16-36-1-17, 16-36-7-42(c), 16-36-7-43). |
Proxy follows known wishes, with best interests when wishes cannot be reliably found; withholding or withdrawing life-prolonging procedures needs evidence supporting that choice or best interests (§ 16-36-7-42(d)–(e)). |
With no authorized available person, a provider or interested person may petition probate court for a decision or representative; court may expedite when delay seriously harms health (§ 16-36-1-8). |
| Iowa verified 2026-10-08 | Terminal condition, inability to communicate, and no relevant declaration for life-support or facility-resuscitation decision; no prior agent or guardian before family route (HF 2305 §§ 9, 11). |
§ 144A.7 life-sustaining procedures; new § 144A.7B resuscitation in listed facilities; § 135J.3A hospice admission/placement (HF 2305 §§ 3, 9, 11). |
Health-care attorney-in-fact or authorized guardian precedes family; equally responsible guardians use majority, then court if tied (HF 2305 §§ 3, 9, 11, 17). |
Spouse; majority of available adult children; both available parents; majority of available adult siblings; majority of available adult relatives (HF 2305 § 9, amending § 144A.7(1)(b)). |
Close adult friend after relatives; must show special care, regular contact, knowledge of patient, and affidavit to attending provider (§ 144A.2(5), § 144A.7(1)(b)(6), HF 2305 §§ 4, 9). |
Majority among children, siblings, and broader adult relatives; both parents when both are available; equally responsible guardians use majority (HF 2305 §§ 3, 9, 11). |
Move down if prior priority is not reasonably available, willing, and competent; close friend's affidavit documents eligibility (HF 2305 §§ 4, 9). |
Life-support route requires terminal condition, incapacity, written clinician agreement and witness; pregnancy exception in § 144A.7(3) (HF 2305 § 9; § 144A.7(3)). |
Guardian tie requires court order; without listed family or friend, these provisions give no further class; § 144A.7B is limited to specified facilities (HF 2305 §§ 9, 11). |
| Kansas verified 2026-10-08 | No general ladder; agent authority follows a written durable health-care POA, guardian authority follows a court appointment, and § 65-4974 applies only when an adult or emancipated minor cannot consent to an approved research protocol. |
No general default-care setting; § 65-4974 is limited to treatment by a physician with medical-staff membership at a facility with an independent institutional review board and to the approved research protocol. |
A written durable health-care POA names an agent; a court-appointed adult guardian may consent to health, mental-health, or other care within the powers granted by the court. Neither statute creates a general provider-selected family ladder. |
Only the research-consent rule gives an order: spouse unless legally separated, adult child, parent, then adult relative by blood or marriage (§ 65-4974(b)). |
No general close-friend or other nonfamily route; § 65-4974(b) ends with an adult relative by blood or marriage. |
Section 65-4974 authorizes a qualifying family member who can be contacted with reasonably diligent efforts; it states no majority or unanimity rule for that research class. |
The research rule requires capacity to provide informed consent and contact through reasonably diligent efforts; an agent is designated in writing and a guardian is appointed by court order with specified powers. |
Research consent cannot authorize a protocol contrary to the incapacitated person's expressed oral or written permission; guardians must follow applicable declarations and durable-POA provisions for life-sustaining care, with additional statutory limits. |
Kansas provides court appointment and court-limited guardian powers, but the current statutes reviewed contain no general clinician, ethics-committee, or family-dispute fallback for ordinary adult care. |
| Kentucky verified 2026-10-08 | Physician finds adult lacks decisional capacity; no advance directive exists or it does not address the decision (§ 311.631(1)). |
Health-care decisions generally; psychiatric hospitalization at a general hospital is limited to 14 consecutive days absent court order (§ 311.631(1), (4)). |
Court-appointed guardian within medical powers, then durable-power attorney-in-fact expressly authorized for health care (§ 311.631(1)(a)–(b)). |
Spouse; adult child or majority of reasonably available adult children; parents; nearest living relative or same-degree majority (§ 311.631(1)(c)–(f)). |
Last listed class is adult friend with regular contact and knowledge of patient’s activities, health, and religious and moral beliefs (§ 311.631(1)(g)). |
Majority of available adult children or nearest relatives of the same relation; statute does not state a parent vote (§ 311.631(1)(d)–(f)). |
Higher-priority person must be reasonably available, willing, and competent; friend needs regular contact and familiarity (§ 311.631(1)). |
Follow directive and best interests; psychiatric hospitalization in general hospital capped at 14 days without court order; artificial nutrition withdrawal only in § 311.629(3) circumstances (§ 311.631(3)–(5)). |
Order passes to next eligible class when a prior class cannot act; friend is final listed class; psychiatric stay beyond 14 days needs court order (§ 311.631(1), (4)). |
| Louisiana verified 2026-10-08 | When adult cannot consent personally and no higher class is reasonably available, willing, and competent (§ 40:1159.4(A)). |
Any physician-directed surgical or medical treatment or procedure not prohibited by law, including autopsy (§ 40:1159.4(A)). |
Judicially appointed tutor or curator, then agent under a valid mandate expressly authorizing health-care decisions (§ 40:1159.4(A)(2)–(3)). |
Spouse not judicially separated; adult child; parent; sibling; other ascendants or descendants (§ 40:1159.4(A)(4)–(8)). |
Qualifying adult friend after family, with signed facility acknowledgment; separate developmental-disability team choices follow (§ 40:1159.4(A)(9), (11)–(12)). |
Majority of class members available for consultation in classes (A)(1)–(9) (§ 40:1159.4(B)). |
Higher class must be reasonably available, willing, competent; adult friend must know patient’s views and sign and date facility acknowledgment (§ 40:1159.4(A)). |
Authority is consent to physician-directed treatment not prohibited by law; developmental-disability team routes have their own selection votes (§ 40:1159.4(A)(11)–(12)). |
Attending physician may act after no (A)(1)–(10) person is reasonably available, with documented search and second-physician confirmation; emergencies have implied consent (§§ 40:1159.4(C)–(D), 40:1159.5). |
| Maine verified 2026-10-08 | Primary physician finds incapacity; life-sustaining-treatment withdrawal also requires terminal condition or persistent vegetative state and no appointed or reasonably available agent/guardian. Other decisions require no agent/guardian exists (§ 5-806(1)). |
Physical or mental health care, providers, institutions and treatment; no single-facility restriction, but residential-care employee conflict rule (§§ 5-802(5)–(6), 5-806(9)). |
An agent’s decision prevails over a guardian’s absent contrary court order; surrogate trigger distinguishes unavailable appointee from nonexistent appointee (§§ 5-806(1), 5-807(2)). |
Spouse; spouse-like adult partner; adult child; parent; adult sibling; adult grandchild; adult niece/nephew; adult aunt/uncle; qualifying adult relative (§ 5-806(2)). |
If no listed family member is reasonably available, a concerned adult familiar with the patient’s values may serve (§ 5-806(3)). |
Provider may follow priority class or majority of its members who communicated views; an informed even split disqualifies that class and lower classes (§ 5-806(5)). |
Reasonably available means reachable without undue effort and willing/able to act timely; patient may disqualify a person; residential-care owner/operator/employee generally barred (§§ 5-802(16), 5-806(2)–(3), (8)–(10)). |
Withdrawal of life-sustaining treatment has terminal/PVS threshold; other decisions cannot deny medically necessary lifesaving care; mental-health-institution admission needs express written directive (§§ 5-806(1), 5-814(5)). |
Provider may refer dispute to neutral third party or court; eligible parties may seek judicial direction or equitable relief (§§ 5-806(5), 5-815). |
| Maryland verified 2026-10-08 | Treatment-specific written incapacity certification; no appointed agent or agent unavailable (§§ 5-605(a)(2), 5-606(a)). |
Health-care decisions generally; hospital or related-institution dispute route differs from care elsewhere (§ 5-605(a)–(b)). |
Appointed agent has priority; an appointed guardian heads the default list (§§ 5-602(b)(4), 5-605(a)(2)(i)). |
Spouse or domestic partner, adult child, parent, adult brother or sister, then qualifying other relative (§ 5-605(a)(2)). |
Close friend may qualify with competence and a specific-contact affidavit to the attending physician (§ 5-605(a)(3)). |
Hospital disagreement: patient care advisory committee; outside a hospital, all same-class people must agree before withholding or withdrawing life-sustaining procedures (§ 5-605(b)). |
Higher class must be unavailable; reasonable inquiry, timely response, ability, and willingness matter; protective order and separated or divorcing spouse disqualifications apply (§ 5-605(a)(1), (2), (4)). |
Follow patient wishes or best interest; no surrogate consent to sterilization or mental-disorder treatment; life-sustaining withdrawal needs specified condition certifications (§§ 5-605(c)–(d), 5-606(b)). |
Hospital committee for equal-rank dispute; qualifying family or friend may seek court injunction; expedited court guardianship is available when needed (§§ 5-605(b), 5-612(b), Est. & Trusts § 13-705(f)). |
| Massachusetts verified 2026-10-08 | Agent's proxy authority starts on written attending-physician incapacity finding; without a proxy, § 16 addresses incompetent or incapacitated patients (§§ 201D:6, 201D:16). |
Proxy agent may make health-care decisions within proxy; § 16 permits provider reliance on responsible-party consent without naming a facility class (§§ 201D:5, 201D:16). |
Effective proxy agent outranks other people, including guardian, unless proxy or court order says otherwise (§§ 201D:5, 190B:5-309(e)). |
No spouse-to-child statutory rank in § 201D:16; it speaks of informed consent from responsible parties to the extent permitted by law. |
No separate friend class in § 201D:16; a responsible party's consent may be relied on only to the extent permitted by law. |
Section 201D:16 gives no majority or unanimity rule for multiple responsible parties. |
A named alternate agent may act if primary is unavailable, unwilling, incompetent, or disqualified; § 16 gives no comparable family search test (§§ 201D:2, 201D:16). |
Proxy agent stays within proxy; patient objection prevails absent court incapacity order; guardian cannot admit to mental-health facility under guardianship chapter (§§ 201D:5, 201D:6, 190B:5-309(f)). |
Court may appoint a guardian after required findings, or a limited temporary guardian to avert immediate substantial harm while petition is pending (§§ 190B:5-306, 190B:5-308). |
| Michigan verified 2026-10-08 | Advanced-illness surrogate is for a patient unable to consent; Social Welfare Act addresses a person not of sound mind or unable to decide (§§ 333.5653(1)(g), 400.66h). |
Advanced-illness treatment under Public Health Code Part 56A; Social Welfare Act treatment under that act; guardian authority follows court order (§§ 333.5654–5655, 400.66h, 700.5314(c)). |
Designated patient advocate has granted powers upon required incapacity finding; guardian cannot exercise the same granted powers absent court modification (§§ 700.5508(1), 700.5306(5)). |
Immediate family or next of kin recognized for advanced illness, but no ordered kin classes in that provision (§§ 333.5653(1)(g), 333.5655(b)). |
Social Welfare Act names a person standing in loco parentis; no general friend class specified in the cited current provisions (§§ 400.66h, 333.5653(1)(g)). |
No majority or same-rank selection rule in the current advanced-illness definition or Social Welfare Act consent sentence (§§ 333.5653(1)(g), 400.66h). |
Current cited family-surrogate provisions give no reasonable-availability test; guardian's powers depend on court order (§§ 333.5653(1)(g), 700.5314). |
Advanced-illness surrogate may decide on receiving, continuing, discontinuing, or refusing that treatment; guardian's inpatient and involuntary mental-health powers have separate limits (§§ 333.5655(b), 700.5314(c)). |
Interested person may petition for guardian; court needs separate clear-and-convincing findings of incapacity and need, and limits the grant to demonstrated need (§§ 700.5303(1), 700.5306(1)–(2)). |
| Minnesota verified 2026-10-08 | No automatic kin trigger; an appointed agent acts on decision-specific incapacity, while a guardian requires a court finding (§§ 145C.06–.07; 524.5-310(a)). |
General health-care decisions are covered by appointed-agent and court-guardian authority; no statewide family-proxy setting appears in the current cited schemes (§§ 145C.01, 145C.07; 524.5-313). |
Authority comes from an appointed agent or court-appointed guardian; guardian powers granted under § 524.5-313(c) can suspend earlier agent authority (§§ 145C.01 subd. 2; 524.5-310(f)). |
No statutory spouse, child, parent, or sibling ladder for general adult care in current ch. 145C or ch. 524.5; court appointment supplies authority (§§ 145C.01 subd. 2; 524.5-310(a)). |
No automatic close-friend class; an adult may act as agent only through appointment under the directive scheme (§§ 145C.01 subds. 2–3, 145C.03 subd. 1). |
No default family class or same-rank vote under the cited agent/guardian statutes (§§ 145C.01 subd. 2, 145C.07 subd. 1; 524.5-310(a)). |
An alternate appointed agent acts if primary agent is not reasonably available; guardianship requires clear-and-convincing incapacity and unmet needs despite less restrictive means (§§ 145C.07 subd. 1; 524.5-310(a)). |
Agent authority tracks decision-specific capacity; guardian receives only court-granted powers and needs prior court approval for specified intrusive care (§§ 145C.07 subd. 1; 524.5-313(b), (c)(4)). |
Court may appoint a limited or unlimited guardian when statutory findings are met; medical-consent power depends on the order (§§ 524.5-310(a), 524.5-313(b)–(c)). |
| Mississippi verified 2026-10-08 | Primary physician determines adult or emancipated minor lacks capacity; no agent or guardian appointed or reasonably available (§ 41-41-211(1)). |
Health-care decisions include providers/institutions, tests, procedures, medication, DNR and nutrition; no general facility limit. Separate fallback applies to residential long-term-care residents (§§ 41-41-203(h), 41-41-215(9)). |
Agent and guardian precede a surrogate; a capable patient's personal designation precedes default family classes. Agent's decision takes precedence over guardian's absent contrary court order (§§ 41-41-211(1)–(2), 41-41-213(2)). |
Reasonably available spouse unless legally separated; adult child; parent; adult brother or sister, in descending order (§ 41-41-211(2)). |
If no listed family member is reasonably available, an available adult who has shown special care and concern and knows the patient's values may act (§ 41-41-211(3)). |
On a reported disagreement among multiple class members assuming authority, provider follows majority of members who communicated views; even split disqualifies that class and lower classes (§ 41-41-211(5)). |
Reasonably available means reachable without undue effort and willing and able to act timely. Patient may disqualify someone; a long-term-care owner, operator, or employee ordinarily cannot be surrogate unless related, subject to state-facility exception (§§ 41-41-203(p), 41-41-211(8)–(10)). |
Surrogate follows known instructions/wishes, otherwise best interest; express mental-health-institution admission limit requires written directive. Facility fallback cannot withhold or discontinue life support, nutrition, hydration, or other care (§§ 41-41-211(6), 41-41-227(5), 41-41-215(9)). |
When no agent, guardian, or surrogate is available, a qualifying residential-care owner/operator/employee may consent only to physician-determined necessary care (§ 41-41-215(9)). Court may direct a health-care decision on petition; § 41-41-9 provides an additional urgent-treatment court route with stated prerequisites. |
| Missouri verified 2026-10-08 | No general adult family-proxy trigger in the checked consent scheme: § 431.061 names self-consent and a guardian for a ward; § 431.064(1) applies when an adult at a qualifying teaching hospital cannot consent to experimental treatment, a test, or a drug. |
Family order in § 431.064(1) is confined to experimental treatment, tests, or drugs at a teaching hospital for an accredited medical school; § 431.061 covers ordinary medical/surgical consent without an adult family ladder. |
Guardian may consent for a ward under §§ 431.061(1)(6), 475.120(3); narrow § 431.064(1) names guardian and attorney-in-fact before family. |
Only for § 431.064's teaching-hospital experimental care: spouse, adult child, parent, brother or sister, then relative by blood or marriage. |
The § 431.064(1) experimental-care list names guardian, attorney-in-fact, and relatives; it supplies no friend class. |
Section 431.064(1) ranks relationships but states no same-rank majority or unanimity method; the general § 431.061(3) one-consenter rule applies to people authorized by that section. |
For the narrow experimental route, spouse yields if absent, separated, incapable, whereabouts unknown, or overseas (§ 431.064(1)(1)); emergency implied consent has separate conditions (§ 431.063). |
Experimental-care surrogate may not override the incapable person's expressed permission (§ 431.064(2)); § 431.063 implies consent only within its medical-emergency conditions. |
For life-threatening procedures with no time for guardian consent, § 475.123(2) allows a documented emergency procedure; court may authorize consent on petition under § 475.123(3)–(4). |
| Montana verified 2026-10-08 | Attending physician/APRN finds terminal condition and inability to decide on life-sustaining treatment; no effective declaration; written consent with two witnesses (§ 50-9-106(1)). |
Withholding or withdrawal of life-sustaining treatment in terminal condition; no facility restriction stated in this provision (§§ 50-9-102(9), (16), 50-9-106(1)). |
Effective declaration controls its own route; full guardian may consent or withhold consent as authorized, with statutory and court limits (§§ 50-9-106(1), (3), 72-5-321(2)(c)). |
Spouse; adult child or available-child majority; parents; adult sibling or available-sibling majority; nearest other available adult blood/adoptive relative (§ 50-9-106(2)). |
No friend or unrelated adult appears in this life-sustaining-treatment consent list (§ 50-9-106(2)). |
Majority of reasonably available adult children or siblings; parents are listed together without an express majority formula; equal division does not pass authority down (§ 50-9-106(2), (4)). |
Next class acts if higher class is unavailable for consultation, incompetent to decide, or declines; nearest other relative must be reasonably available (§ 50-9-106(2), (4)). |
Written two-witness consent; good faith and no conflict with patient’s expressed intent; pregnancy restriction where fetal live birth is probable (§ 50-9-106(1), (5), (7)). |
An equal class split does not authorize the next class; full guardian may petition court for treatment-withdrawal or DNR authority within ward-wishes limit (§§ 50-9-106(4), 72-5-321(2)(c)). |
| Nebraska verified 2026-10-08 | An adult (19 or older) or emancipated minor is incapable as determined by the primary provider; no agent or guardian has been appointed (§§ 30-603(1), (13), 30-604(1), 30-606). |
Covers physical and mental health care, including facilities and services; no general hospital-only limit, but transfer to another facility ends existing surrogate authority (§§ 30-603(7)–(11), 30-604(6)(d)). |
Existing agent or guardian keeps the statutory surrogate route closed. A capable patient's personal surrogate designation precedes the family classes (§§ 30-604(1)–(2), (9)). |
Spouse unless separated or divorce, annulment or separation proceedings pending; adult or emancipated child; parent; adult or emancipated sibling (§ 30-604(2)(b)). |
A reasonably available person who has shown special care and concern and knows the patient's values is eligible; the statute does not number that person within the family classes (§ 30-604(3)). |
Same-class claimants agreeing must sign and date a common writing; disagreement calls for consensus efforts. If timely consensus fails, those claimants are disqualified and provider may seek others in same or lower classes (§ 30-604(5)). |
Reasonably available means reachable without undue effort and able and willing to act timely. Provider may disqualify an abusive or disloyal candidate on clear evidence; patient may disqualify someone; unrelated institutional staff cannot serve (§§ 30-603(21), 30-604(2)(d), (7), 30-605). |
Follow known wishes or best interests. Withdrawing life support or artificial nutrition/hydration requires terminal condition or persistent vegetative state, extraordinary/disproportionate treatment, and explicit authority proved by clear and convincing evidence; comfort care and usual oral food/fluid remain (§§ 30-609(1), 30-610). |
Provider seeks consensus, may use an ethics consultation, then other eligible people; if none is available, provider may act or decline under statutory standards. County court hears capacity and authority challenges (§§ 30-604(5), 30-608, 30-612–613). |
| Nevada verified 2026-10-08 | Adult lacks capacity for resuscitation/life-sustaining wishes; no representative and no valid POLST signed by patient or representative (§ 449A.551(3)–(4)). |
POLST for emergency and life-sustaining treatment, intended for any care setting; family route is for requesting and signing that form (§§ 449A.542, 449A.548(3)–(4), 449A.551). |
Patient if capable; otherwise legal guardian, designated life-support decision maker, or health-care POA agent as representative before default surrogate (§§ 449A.545, 449A.551(3)–(4)). |
Spouse; available adult-child majority; parents; available adult-sibling majority; nearest other adult relative by blood or adoption (§ 449A.551(7)(a)(1)–(5)). |
Final class is an adult showing special care or concern, familiar with patient's values, and willing and able to decide (§ 449A.551(7)(a)(6)). |
Available adult-child and sibling majority; an even division does not move authority to next class (§ 449A.551(6)(a), (7)(a)). |
Next class acts when prior class is not reasonably available for consultation and capable, or declines; decision must be in good faith and consistent with expressed intention (§ 449A.551(6)). |
Clinician completes POLST from preferences and medical indications; surrogate form decision cannot conflict with patient's expressed intention (§ 449A.551(3), (6)(b)). |
Evenly divided class cannot yield to lower class; clinician's good-faith validity decision is conclusive under this POLST section (§ 449A.551(6)). |
| New Hampshire verified 2026-10-08 | Attending practitioner certifies lack of health-care decision capacity in medical record and reasonably inquires for an available agent or guardian (§§ 137-J:2, 137-J:35(I)–(II)). |
Consent, refusal, or withdrawal for physical or mental care, procedures, or admission; no single-facility limit (§ 137-J:2). |
Authorized available health-care agent and legal guardian are checked before a surrogate is identified; no surrogate over patient’s express objection (§§ 137-J:35(I)–(II), 137-J:37(I)). |
Spouse/civil union or common-law spouse; adult child; parent; adult sibling; adult grandchild; grandparent; adult aunt, uncle, niece, or nephew (§ 137-J:35(I)(a)–(g)). |
Close friend with statutory affidavit; then financial-power-of-attorney agent or conservator; then estate guardian (§§ 137-J:2(IX), 137-J:35(I)(h)–(j)). |
Same-rank surrogates seek consensus; on reported disagreement, available-person majority controls unless minority or interested party starts guardianship, suspending recognized surrogate (§ 137-J:36(I)). |
Practitioner makes reasonable inquiry; person must be an available, willing, capable adult and named in medical record. Higher-priority willing person may replace current surrogate (§§ 137-J:2, 137-J:35(II), 137-J:36(II)–(IV)). |
Patient’s objection prevents or terminates surrogacy. Surrogate acts for at most 180 days unless patient is actively dying; authority ends earlier on capacity recovery or guardian appointment (§ 137-J:37(I), (V)). |
Guardianship challenge suspends recognized surrogate while pending, without preempting care. Practitioner may seek or encourage guardianship if no decision-maker, but need not (§§ 137-J:36(I), (IV), 137-J:37(III)–(IV)). |
| New Jersey verified 2026-10-08 | Representative acts after a decision-specific capacity determination to implement an advance directive; guardianship requires court action (§§ 26:2H-60(f), 26:2H-61(a), 3B:12-25). |
Representative may decide health care within the directive; guardian may consent to medical care within court order; § 26:14-5 ladder is for medical research (§§ 26:2H-61, 3B:12-57(f), 26:14-5(a)). |
Designated health-care representative retains decision authority despite a different legal guardian unless a court order says otherwise (§ 26:2H-61(b)). |
No automatic ordinary-treatment kin sequence in the cited provisions; spouse or domestic partner receives preference for court-issued guardianship letters (§§ 26:2H-58(a), 3B:12-25). |
Patient may designate a friend or other adult; court may consider friends for guardianship, but those routes require designation or appointment (§§ 26:2H-58(a)(1), 3B:12-25). |
No ordinary-treatment family vote in the cited scheme; any available same-priority person's dissent prevents research consent (§ 26:14-5(c)(1)). |
Proxy directive may name priority-ranked alternates if primary is unavailable, unable, unwilling, or disqualified; guardianship choices depend on court action (§§ 26:2H-58(a)(3), 3B:12-25). |
Representative stays within directive and acts in good faith; guardian respects valid directives and court limits (§§ 26:2H-61(a), 3B:12-56(c), 3B:12-57(f)). |
Superior Court may appoint a guardian; a temporary guardian may receive interim medical authority for critical need or risk of substantial harm (§§ 3B:12-25, 3B:12-24.1(c)). |
| New Mexico verified 2026-10-08 | Adult or emancipated minor lacks capacity under the two-professional determination; no agent or guardian appointed or reasonably available (§§ 24-7A-5(A), 24-7A-11(C)). |
Physical or mental health care, including practitioners, institutions, tests, medication, life support, and nutrition; no general facility restriction (§ 24-7A-1(F)–(H)). |
An appointed agent or guardian precedes the surrogate; a capable patient’s personal designation precedes the family order. Agent decisions prevail over guardian decisions absent contrary court direction (§§ 24-7A-5(A)–(B), 24-7A-6(B)). |
Spouse unless separated or dissolution petition pending; qualifying long-term partner; adult child; parent; adult sibling; grandparent (§ 24-7A-5(B)). |
If no designated person or listed family member is reasonably available, an available adult with special care and concern who knows the patient’s values may act (§ 24-7A-5(C)). |
On a reported disagreement, provider follows majority of class members who communicated views; an even split disqualifies that class and lower classes for that decision (§ 24-7A-5(E)). |
Reachable without undue effort and willing and able to act timely; patient may disqualify anyone. Unrelated institution owners, operators, and employees cannot act; provider may demand a sworn declaration (§§ 24-7A-1(S), 24-7A-5(I)–(K)). |
Follow known instructions and wishes, otherwise best interest informed by values; no decision solely on disability. No surrogate consent to mental-health-facility admission; an express written directive permits presentation for evaluation (§§ 24-7A-5(F)–(G), 24-7A-13(E)). |
A qualifying petitioner may seek a district court order directing or enjoining a health-care decision; an even class split bars that class and lower classes (§§ 24-7A-5(E), 24-7A-14). |
| New York verified 2026-10-08 | Attending practitioner determines incapacity; a health care agent takes priority (§§ 2994-b(2), 2994-c(2), 2994-d(3)(b)). |
Hospital-provided care; hospice decisions anywhere; mental-hygiene hospital DNR decisions (§ 2994-b(1)–(1-a)). |
Authorized Article 81 guardian heads the list; appointed health care agent governs ahead of this ladder (§§ 2994-b(2), 2994-d(1)(a)). |
Spouse (unless legally separated) or domestic partner → adult child → parent → adult sibling (§ 2994-d(1)(b)–(e)). |
Close friend, including certain other relatives, must present signed familiarity statement (§§ 2994-a(4), 2994-d(1)(f)). |
One person from highest available class acts; a qualifying person may designate another listed person subject to higher-class objection (§ 2994-d(1)). |
Higher classes must be reasonably unavailable, unwilling, or incompetent; facility staff and treating clinicians face conflict limits (§ 2994-d(1)–(2)). |
Follow patient wishes or best interests; life-sustaining withdrawal needs § 2994-d(5) clinical findings and sometimes ethics or court review. |
No surrogate: § 2994-g practitioner/second-review routes; ethics committee advises on disputes; court may designate or remove one (§§ 2994-g, 2994-m, 2994-r). |
| North Carolina verified 2026-10-08 | Comatose or otherwise unable to make or communicate health-care decisions (§ 90-21.13(c)). |
Consent to medical treatment; the grant is framed by treatment, not a named facility (§ 90-21.13(c)). |
Guardian of person or general guardian first, subject to a valid health-care agent's granted authority; appointed agents follow (§ 90-21.13(c)(1)–(3)). |
Spouse; combined adult parents and children; adult siblings (§ 90-21.13(c)(4)–(6)). |
Established relationship, good faith, and ability to reliably convey patient's wishes (§ 90-21.13(c)(7)). |
Majority of reasonably available adult parents and children together; then majority of reasonably available adult siblings (§ 90-21.13(c)(5)–(6)). |
Parents, children, and siblings must be at least 18 and reasonably available; friend must meet relationship and good-faith criteria (§ 90-21.13(c)(5)–(7)). |
Other listed statutes control on conflict; withholding life-prolonging measures without a declaration has added medical findings and concurrence requirements (§§ 90-21.13(e), 90-322(a)–(b)). |
If no listed person is reasonably available, attending physician may treat with second-physician confirmation, except when delay would endanger life or seriously worsen condition (§ 90-21.13(c1)). |
| North Dakota verified 2026-10-08 | Adult cannot understand/appreciate and communicate decision; attending physician, psychiatrist or psychologist certifies and files finding (§ 23-12-13(1)(a)). |
Informed consent to proposed health care for an incapacitated adult; no single-facility restriction in this provision (§ 23-12-13(1)–(2)). |
Health-care directive agent, then appointed guardian or custodian unless court orders otherwise (§ 23-12-13(2)(a)–(b)). |
Significant-contact spouse; adult child; parent including stepparent; adult sibling; grandparent; adult grandchild; adult close relative or friend (§ 23-12-13(2)(c)–(i)). |
Adult close friend with significant contact; last, team of at least three health-care professionals with an uninvolved member and continuing higher-priority search (§ 23-12-13(2)(i)–(j)). |
Provider seeks a competent person in the first reachable class; higher-priority refusal bars consent from a lower class; court may determine otherwise (§ 23-12-13(2), (4)). |
Provider makes reasonable efforts to locate competent first/succeeding class; significant contact required for listed family/friend classes; lower class only if higher unavailable (§ 23-12-13(2), (4)). |
First assess what patient would consent to, then best interest if unknown; no sterilization, abortion, psychosurgery or state mental-health admission over 45 days absent court route (§ 23-12-13(5)–(6)). |
Three-professional team last; capacity objection by patient/interested person requires guardianship-court hearing (§ 23-12-13(2)(j), (7)). |
| Ohio verified 2026-10-08 | Adult terminal or unconscious for at least 12 months; two-physician findings, no effective declaration/health care POA (§ 2133.08(A)). |
Withholding or withdrawal of life-sustaining treatment under § 2133.08; nutrition/hydration has separate § 2133.09 process. |
Guardian first; effective declaration or health care POA prevents this family-consent route (§ 2133.08(A)(1)(b),(B)(1)). |
Spouse → adult child/majority of children → parents → adult sibling/majority of siblings → nearest adult blood/adoptive relative (§ 2133.08(B)). |
No friend class in the § 2133.08(B) list; final class is an adult blood/adoptive relative. |
Majority of available adult children or siblings; an equal division in any priority class yields no consent (§ 2133.08(B)(3),(5),(C)(1)). |
Available in reasonable time, competent, sound mind, voluntary; pending marital case, protection order, or specified assault charge can bar (§ 2133.08(A),(C)). |
Written consent with two eligible witnesses; patient wishes govern; pregnancy restriction; nutrition/hydration needs added findings and probate order (§§ 2133.08, 2133.09). |
Unavailable/declining class yields to next; a tie does not. Qualifying relatives may object and seek probate reversal on strict deadlines (§ 2133.08(C),(E)). |
| Oklahoma verified 2026-10-08 | Adult is persistently unconscious, incompetent, or otherwise mentally or physically unable to communicate; decision maker must be reasonably available and willing (§ 3102.4(A)). |
Health-care decisions for the qualifying patient; § 3102.4 does not limit the route to a named facility (§ 3102.4(A)). |
Authorized general or limited guardian; designated health-care proxy or alternate; authorized Health Care Agent Act attorney-in-fact (§ 3102.4(A)(1)–(3)). |
Spouse; adult children; parents; adult siblings; other adult relatives in order of kinship (§ 3102.4(A)(4)–(8)). |
Close friends with regular contact sufficient to know the patient's values rank last; a fact-specific affidavit is prima facie evidence (§ 3102.4(A)(9)). |
If people within one class disagree, its majority may decide (§ 3102.4(A)). |
Reasonably available and willing; abuse or exploitation history specified in § 3102.5 disqualifies; decision maker supplies a signed eligibility statement (§§ 3102.4(A)–(B), 3102.5(A)). |
Apply the patient's known intentions, views, and best interests using the § 3101.16 standard; sufficient evidence of the patient's wishes controls (§§ 3102.4(A), 3101.16). |
Provider or listed class member may seek a guardianship-court order changing a decision or assigning supervening authority on the specified showing (§ 3102.4(A)). |
| Oregon verified 2026-10-08 | Family route requires incapacity, no appointed representative or applicable directive, and a medically confirmed qualifying condition (§ 127.635(1)–(2)); hospital route requires inability to decide and failed searches (§ 127.760(3)). |
Family order covers life-sustaining withdrawal; separate hospital route covers medically necessary inpatient care; service-team advocate route covers qualifying developmental-disability services (§§ 127.635, 127.760, 127.765). |
Available appointed health-care representative has priority; in the § 127.635 family route an authorized guardian ranks first (§§ 127.535(1), 127.635(2)(a)). |
Authorized guardian; spouse; adult unanimously designated by reachable listed people; majority of adult children; either parent; majority of adult siblings; adult relative or friend (§ 127.635(2)). |
Adult friend is final family-route class; hospital may appoint ethics-trained provider after failed search; service team may appoint advocate for qualifying disability services (§§ 127.635(2)(g), 127.760(2)–(3), 127.765(2)–(3)). |
Majority of reachable adult children or siblings; designated adult needs no objection from reachable listed people; no vote specified for final relative/friend class (§ 127.635(2)(c)–(g)). |
Facility makes reasonable effort to locate a willing family-route representative; hospital route requires searches for representative, relative or friend, and instruction (§§ 127.635(2), 127.760(3)). |
Family route requires qualifying condition, consultation, and provider supervision; nutrition/hydration has statutory presumption and exceptions; hospital appointee cannot consent to listed sensitive care (§§ 127.580, 127.635, 127.760(5)). |
If no § 127.635 person is available, attending clinician may supervise life-sustaining withdrawal; hospital may appoint ethics-trained provider for necessary care after searches (§§ 127.635(3), 127.760(2)–(3)). |
| Pennsylvania verified 2026-10-08 | Attending physician finds incompetence; no health care POA/available agent or appointed decision-making guardian (§ 5461(a)). |
Health care decisions under § 5461; includes specified care-dependent caretaker services (§ 5461(b)). |
Appointed decision-making guardian excludes this route; agent takes precedence; individually designated representative precedes default classes (§ 5461(a),(d)(1)). |
Spouse (no divorce action) + principal’s adult children who are not spouse’s children → other adult child → parent → adult sibling → adult grandchild (§ 5461(d)(1)(i)–(v)). |
Next, adult knowledgeable about the individual’s preferences and values; individual may designate representative directly (§ 5461(d)(1)). |
Majority of same-class members who communicate views may decide; even division blocks a lower class (§ 5461(g)). |
Reasonably available; patient may disqualify; court may disqualify for cause; unrelated treating providers/facility staff barred (§ 5461(d)–(f)). |
Representative follows agent decision standards; life-preserving care and pregnancy restrictions apply; separate mental-health consent law remains (§§ 5429, 5456(c), 5461(c), 5462(c), 5463(a)). |
Tie leaves no decision while unresolved; accepted medical care remains possible; court may disqualify for cause (§ 5461(e),(g)). |
| Rhode Island verified 2026-10-08 | No general default family trigger in the checked health and guardianship provisions; MOLST decision maker must already be authorized by law or patient (§§ 23-4.11-2(7), 23-4.11-3.1(b)(2)). |
General care consent belongs to the patient or appointed agent; terminal-care MOLST provision covers qualified patient and life-sustaining orders (§§ 23-4.6-1(a), 23-4.10-2, 23-4.11-2(16), 23-4.11-3.1). |
Patient-appointed health-care agent has document-granted authority; court-appointed guardian acts within order and best-interest duty (§§ 23-4.10-2, 33-15-8, 33-15-29). |
No spouse, child, parent or sibling ranking supplied by the checked health-care and guardianship provisions (§§ 23-4.10-2, 23-4.11-2(7), 33-15-8). |
No default close-friend class in the checked provisions; an individual may designate an agent (§§ 23-4.10-2, 23-4.11-2(7)). |
No same-rank vote is prescribed by the checked provisions because they do not create ranked family classes (§§ 23-4.10-2, 23-4.11-2(7)). |
MOLST decision maker must have authority from law or patient; limited guardian has only order-granted authority (§§ 23-4.11-2(7), 33-15-8). |
MOLST authority concerns qualified terminal patients; a recognized maker may sign when capacity is lacking; guardian acts for ward’s best interest (§§ 23-4.11-2(16), 23-4.11-3.1(b)(2), (d)(2), 33-15-29). |
Checked statutes supply no family tie-break or clinician appointment rule; guardian authority depends on court order (§§ 23-4.11-2(7), 33-15-8). |
| South Carolina verified 2026-10-08 | Two examining physicians ordinarily certify inability to consent; emergency professional certification and qualifying hospice certification are alternatives (§ 44-66-20(8)). |
Statewide provider-based care, including physical or mental treatment, nursing and rehabilitation care, and facility placement or removal (§ 44-66-20(1), (7)). |
Court-appointed guardian within guardianship scope, then appointed attorney-in-fact within delegated scope (§ 44-66-30(A)(1)–(2)). |
Eligible spouse; adult children; parent; adult siblings; grandparents; then close adult relative by blood or marriage (§ 44-66-30(A)(3)–(8)). |
Next, a person authorized by another statute; last, a qualifying adult with an established relationship and notarized facility form (§ 44-66-30(A)(9)–(10)). |
Majority of reasonably available adult children, adult siblings, grandparents, or other qualifying adult relatives; equal-rank dispute may go to probate court (§ 44-66-30(A)(4), (6)–(8), (C)). |
Document search; skip a person unavailable, unwilling, or unable to consent. Known patient objection excludes classes (A)(5)–(10) (§ 44-66-30(B), (D)–(E)). |
Follow ascertainable wishes, otherwise best interests; temporary inability may require waiting; known contrary religious beliefs or clear prior instructions limit care (§§ 44-66-30(F)–(H), 44-66-60). |
Probate court may resolve equal-rank disagreement; §§ 44-66-40 and -50 allow limited care without consent when an authorized person is not available. |
| South Dakota verified 2026-10-08 | Adult incapable of informed consent by guardianship, court or signed attending-physician finding; no agent/guardian or neither available (§§ 34-12C-2, 34-12C-3). |
Physical or mental care and licensed-facility admission/personal care; chapter excepts specialized treatment areas (§§ 34-12C-1(3), 34-12C-8). |
Available health-care power-of-attorney agent or guardian precedes the statutory family list (§ 34-12C-3). |
Spouse not legally separated; adult child; parent; adult sibling; grandparent or adult grandchild; adult aunt/uncle/cousin/niece/nephew (§ 34-12C-3(1)–(6)). |
Close friend who gave significant care, showed concern and maintained regular contact familiarizing them with patient’s life and beliefs (§§ 34-12C-1(8), 34-12C-3(7)). |
Nonunanimous decisions by two or more available same-class people allow circuit-court intervention (§ 34-12C-4(2)). |
Provider knows person exists and in good faith judges the person reasonably available, willing and competent; patient may disqualify family before adjudication (§§ 34-12C-1(7), 34-12C-3). |
Follow known express wishes or good-faith best interests; chapter does not change abortion/sterilization or life-prolonging-treatment withdrawal law (§§ 34-12C-3, 34-12C-8(6)–(7)). |
Circuit court may decide, choose a decision-maker or grant other relief on no available person, same-class disagreement or other listed grounds (§§ 34-12C-4, 34-12C-5). |
| Tennessee verified 2026-10-08 | Designated physician finds lack of capacity; agent or guardian absent or not reasonably available; provider also checks patient-designated surrogate (§ 68-11-1806(a)–(c)). |
Health-care decisions for adult patients; provider records selected surrogate in current clinical record of treating institution (§ 68-11-1806(b)–(c)). |
Patient may designate an eligible surrogate; agent decision precedes guardian absent court order, and either available decision maker precedes provider selection (§§ 68-11-1806(a)–(c), 68-11-1807(b)). |
Selection preference: spouse unless separated; adult child; parent; adult sibling; other adult relative; provider also weighs best-qualified criteria (§ 68-11-1806(c)(3)–(4)). |
Another adult meeting care, values, availability, and willingness tests may be selected after family preference classes (§ 68-11-1806(c)(2)–(4)). |
Provider selects the best-qualified person using statutory criteria; § 68-11-1806(c)(3)–(4) states no same-class majority vote. |
Adult must know values, show care, be available and willing; protective-order subject and most involved providers excluded; provider may require sworn declaration (§ 68-11-1806(c)(2), (g)–(h)). |
Undesignated surrogate needs two physicians' clinical-record certifications before withholding or withdrawing artificial nutrition or hydration (§ 68-11-1806(e)). |
If no eligible person is available, designated physician uses ethics recommendations or independent second-physician concurrence; selection challenge carries rebuttable validity presumption (§ 68-11-1806(c)(5)–(6)). |
| Texas verified 2026-10-08 | Adult is comatose, incapacitated, or unable to communicate; no reasonably available guardian or medical-POA agent (§ 313.004(a)). |
Licensed hospital or nursing home, home/community support agency, or county/municipal jail (§§ 313.002(8), 313.004(a)). |
Guardian or medical-POA agent checked before family; family route requires diligent unavailability inquiry (§ 313.004(a)). |
Spouse → adult children → parents → nearest living relative (§ 313.004(a)(1)–(4)). |
No friend class in § 313.004(a); an uninvolved physician may instead concur when no listed person is available (§ 313.004(a-1)). |
No class vote stated; disputes over who may act go to an estate-jurisdiction court (§ 313.004(a)–(b)). |
Adult with capacity, willing and reasonably available after diligent inquiry; physician records contact efforts (§§ 313.004(a), 313.005(b)). |
No life-sustaining withdrawal under Chapter 313; psychiatric/ECT and jail-specific limits; jail surrogate term capped (§§ 313.003, 313.004(d)–(f)). |
Uninvolved physician concurrence when no listed person; court of record resolves authority disputes (§ 313.004(a-1),(b)). |
| Utah verified 2026-10-08 | Patient lacks decision capacity under a documented finding or court order; no appointed agent or authorized guardian is reasonably available (§§ 75A-9-103(2), 75A-9-111(1), 75A-9-117(1)). |
General health-care decisions under § 75A-9-111; final independent-physician route requires residence or care in a health-care institution (§ 75A-9-111(6)). |
Appointed agent or authorized guardian precedes default order; previously identified adult is first default class (§ 75A-9-111(1)–(2)(a)). |
Qualifying spouse; adult child or parent together; cohabitant; adult sibling; adult grandchild or grandparent; qualifying adult stepchild later (§ 75A-9-111(2)(b)–(h)). |
Routinely involved supported-decision adult, caring adult familiar with values, then institution-designated independent physician with ethics consensus (§ 75A-9-111(2)(g)–(j), (6)). |
Majority of highest class members who communicate views and meet duties; solicit remaining available members on an even split (§ 75A-9-112(1)–(4)). |
Reasonably available and not disqualified; patient may disqualify a person; dangerous or certain facility-affiliated people are barred; clinician may request sworn declaration (§§ 75A-9-111(2)–(4), 75A-9-113). |
Follow known wishes, else best interests; mental-health admission, long nursing-home placement, and withdrawal of routine disability support have express limits (§§ 75A-9-116, 75A-9-117(5)–(7), 75A-9-118). |
After search failure, institution may designate independent physician with ethics consensus and notice; unresolved even class split follows other Utah law (§§ 75A-9-111(6)–(9), 75A-9-112(4)). |
| Vermont verified 2026-10-08 | Clinician finds adult lacks capacity; no agent or authorized guardian; no contrary directive or patient objection for DNR/COLST surrogate (§ 9731(b)). |
Surrogate consent only for DNR/COLST orders, used in outpatient and facility care; separate family/close-person hospice election (§§ 9700, 9701(6), 9710, 9731(a)). |
Appointed directive agent or authorized guardian prevents § 9731 surrogate route; their absence/unavailability opens hospice election (§§ 9710(a), 9731(b)(2)–(4)). |
No ranked family ladder: spouse, adult child, parent, adult sibling, adult grandchild and clergy are eligible interested individuals (§§ 9701(18), 9731(c)–(d)). |
Patient may orally designate interested individual; otherwise a caring adult familiar with values may qualify; unrelated treating/facility personnel excluded (§§ 9701(18), 9731(a)(2), (c)). |
Only one surrogate at a time; all interested individuals agree on DNR/COLST decision or designate one to decide; disagreement over designation may go to Probate Division (§ 9731(a)(1), (d)). |
Clinician reasonably attempts notice to available interested people; surrogate willing to follow patient values and consult clinician; no action over patient objection (§ 9731(c)). |
DNR/COLST decision follows patient wishes and values under substituted judgment; patient consent supersedes on recovered capacity; hospice election protects wishes (§§ 9710(a), 9731(e), (g)). |
Interested person may petition Probate Division for guardianship if interested people cannot agree on surrogate; § 9731 gives no general-care fallback (§§ 9700, 9731(d)(2)). |
| Virginia verified 2026-10-08 | Patient is found incapable; no applicable directive instruction or appointed agent for the decision (§§ 54.1-2983.2, 54.1-2986(A), 54.1-2986.1(A)). |
Attending physician may provide, continue, withhold, or withdraw health care; § 54.1-2986(A) does not limit this route to listed facility types. |
Appointed agent outranks § 54.1-2986 list; guardian is first on that list, but guardianship is not required (§§ 54.1-2986(A)(1), 54.1-2986.1(A)). |
Spouse unless divorce action is pending; adult child; parent; adult sibling; other relatives by descending blood relationship (§ 54.1-2986(A)(2)–(6)). |
Last: qualifying unrelated adult with special care, concern, and knowledge of values; committee or two independent physicians confirm (§ 54.1-2986(A)(7)). |
On reported disagreement in classes 3–7, physician may rely on a majority of reasonably available members; no stated guardian or spouse vote (§ 54.1-2986(A)). |
Physician must not know of an available, willing, capable higher-class person; unrelated adult cannot be an involved provider's director, employee, or agent (§ 54.1-2986(A)). |
Unrelated adult cannot withdraw or withhold life-prolonging procedure; written organ-donor intent cannot be hindered; patient protest invokes special limits (§§ 54.1-2986(A)(7), (B), 54.1-2986.2). |
Circuit court may enjoin unauthorized care; any person may seek an otherwise available court order for care (§ 54.1-2985.1). |
| Washington verified 2026-10-08 | Provider reasonably finds and records decision-specific incapacity; then seeks an authorized person in priority order (RCW 7.70.065(1)). |
Consent for health care; definition includes physical or mental care by a provider, with no named facility-only limit in the adult ladder (RCW 7.70.065(1), (4); 70.02.010(15)–(16)). |
Appointed guardian first; durable health-care power of attorney holder second (RCW 7.70.065(1)(a)(i)–(ii)). |
Spouse or registered partner; adult children; parents; adult siblings; familiar adult grandchildren, nieces/nephews, then aunts/uncles (RCW 7.70.065(1)(a)(iii)–(ix)). |
Qualified close friend last; signed perjury declaration lasts up to six months, and provider may decline to rely on it (RCW 7.70.065(1)(a)(x)). |
All available people in a class must agree; a higher-priority refusal bars lower-class consent (RCW 7.70.065(1)(b)). |
Provider makes reasonable efforts to find a competent higher-class person; close friend must be available, familiar with values, and outside barred care-provider roles (RCW 7.70.065(1)(a)(x), (b)). |
Surrogate first seeks patient's likely consent, then best interests; cannot exercise Death with Dignity Act rights for patient (RCW 7.70.065(1)(c)–(d)). |
Recognized emergency may imply consent if patient cannot consent and authorized person is not readily available; court may appoint a guardian after petition and findings (RCW 7.70.050(4); 11.130.265(1)). |
| West Virginia verified 2026-10-08 | A personally examining qualified clinician documents incapacity; attending physician or advanced nurse practitioner selects surrogate if no authorized, capable and willing agent or guardian can serve (§§ 16-30-7, 16-30-8(a)). |
Health decisions include medical, psychiatric, nursing, hospital, nursing-home, home-health, and life-prolonging care; selection may continue across transfers under reassessment rules (§§ 16-30-3, 16-30-13). |
Authorized medical-power-of-attorney representative or court-appointed guardian is checked before selecting a surrogate; statute does not rank those two against each other (§ 16-30-8(a)–(b)). |
Spouse; adult children; parents; adult siblings; adult grandchildren, subject to clinician’s documented best-qualified lower-rank exception (§ 16-30-8(a)–(b)). |
Close friends follow adult grandchildren; a designated other person or entity, including agencies and public guardians, follows (§ 16-30-8(a)(6)–(7)). |
With several same-rank candidates, clinician makes reasonable inquiry and selects best qualified using wishes, contact, concern, visit availability and provider contact (§ 16-30-8(b)(1)). |
Clinician makes reasonable inquiry for candidates; surrogate must be 18 or older, reasonably available and capable. Treating providers and specified unrelated staff are barred (§§ 16-30-3, 16-30-8(a), (i)). |
Surrogate follows known wishes and beliefs, otherwise best interests. Provider reliance requires no contrary directive, religious conflict or actual notice of opposition; an objection to withholding life-prolonging care triggers a 72-hour implementation notice absent court order (§§ 16-30-8(d), (f), 16-30-9). |
Ranked candidate may seek circuit-court or Supreme Court of Appeals review or injunction; selected surrogate otherwise acts without court order. A lower-priority candidate may be chosen with recorded reasons (§ 16-30-8(b)–(c), (e)–(f)). |
| Wisconsin verified 2026-10-08 | Incapacity found by two physicians or a physician and advanced practice clinician; no valid health-care POA or Wisconsin incompetency adjudication (§ 50.06(2), (4)(a)). |
Direct hospital-to-nursing-home or community-based residential facility admission; ensuing care at that facility (§§ 50.01(1m), 50.06(2), (5)). |
This route requires no valid health-care POA or prior Wisconsin incompetency adjudication; guardian appointment ends representative authority (§§ 50.06(2), (5); 155.05(2)). |
For this admission: spouse or registered domestic partner, adult child, parent, adult sibling, grandparent, adult grandchild (§ 50.06(3)). |
Adult close friend is last in the admission order (§ 50.06(3)(g)). |
Same- or higher-priority person may block the admission by disagreement; a cohabiting listed person also may object, subject to two exceptions (§ 50.06(2)(a), (am)). |
Two personal examinations and signed incapacity statement; patient must meet diagnosis and admission conditions. No-petition route needs sworn declaration and higher-class family absence or unwillingness (§ 50.06(2), (4), (8)(a)). |
Guardian-equivalent health-care authority lasts 60 days or until discharge/guardian, with limited 30-day discharge extension; no-petition route ends on specified events. New no-petition admissions stop after June 1, 2029 (§ 50.06(5)–(6)). |
Ordinary route requires guardianship and protective-placement petitions; protest triggers county review. No-petition route allows court review of representative conduct (§ 50.06(2)(c)–(d), (8)(e)). |
| Wyoming verified 2026-10-08 | No valid advance health-care directive; primary physician or provider finds lack of capacity; no appointed or reasonably available agent/guardian (§ 35-22-406(a)). |
Health-care decisions include provider selection, tests, medication, DNR and artificial nutrition/hydration; no single-facility restriction (§§ 35-22-402(a)(ix), 35-22-406(a)). |
Agent or guardian ahead of surrogate; agent decision prevails over guardian absent contrary court order (§§ 35-22-406(a), 35-22-407(b)). |
Patient designee first; suggested order is spouse not legally separated, adult child, parent, grandparent, adult sibling, adult grandchild (§ 35-22-406(b)). |
After unavailable family, caring adult familiar with patient values may act; unrelated residential/community facility owner, operator or worker barred (§ 35-22-406(c), (j)). |
If same-class members disagree and provider is told, provider follows majority of members who communicated their views (§ 35-22-406(e)). |
Surrogate must be adult, capable, reasonably available and willing; provider may require perjury declaration; patient may disqualify by writing or personal notice (§§ 35-22-402(a)(xvi), (xx), 35-22-406(h), (k)). |
Follow patient instructions and known wishes, then best interests and values; Act preserves separate involuntary mental-health law (§§ 35-22-406(f), 35-22-414(e)). |
Decision effective without judicial approval; patient, listed decision-makers or provider may seek district-court direction or injunction (§§ 35-22-406(g), 35-22-415). |
All 51 jurisdictions verified. Each state page shows the statute text and verification date behind its row.
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