Default Health-Care Surrogate Priority in Utah

At a glance

Requirements one by one

When the default order opens

Under § 75A-9-111(1), a default surrogate acts for a person who lacks capacity to make the decision when no appointed agent or authorized guardian has been appointed or is reasonably available. Under § 75A-9-103(2), a noncourt capacity finding requires a contemporaneous professional examination and signed record, with specified qualifications and exclusions for the examiner. Under § 75A-9-117(1), surrogate power stops if capacity returns or the patient objects to the finding, subject to the statute's further review route.

Priority and disagreement

Section 75A-9-111(2) begins with an adult the patient identified outside a health-care power of attorney, a qualifying spouse, an adult child or parent at the same rank, a cohabitant, an adult sibling, an adult grandchild or grandparent, a person routinely assisting supported decision making, a qualifying stepchild, and an adult with special care and knowledge of the patient's values. A separated or deserting spouse may be excluded under subsection (2)(b). Subsection (3) permits the responsible clinician to request a sworn declaration supporting authority.

Under § 75A-9-112(2), the professional follows the majority of the highest class members who communicate their views and appear to follow statutory duties. On an even split, the acting surrogate must try to obtain views from other reasonably available members; a tie that persists is governed by other Utah law, not a vote by a lower class.

Eligibility and decision limits

Under § 75A-9-113, the patient may disqualify someone by signed record or clear verbal or nonverbal communication, even when the patient cannot make an advance directive. It also bars a person found dangerous by a court, certain residential-facility owners and workers, and a person who refuses a timely requested declaration. Under § 75A-9-116, the surrogate follows ascertainable wishes; if those cannot be found, the surrogate determines best interests with attention to current communication, values, risks, and benefits.

Section 75A-9-117(5)–(7) limits voluntary mental-health admission and nursing-home placement beyond 100 days unless the stated advance-directive authority exists. Under § 75A-9-118, routine artificial nutrition, hydration, or ventilation used without objection by a person with a long-term disability is protected, subject to its express exceptions.

What trips people up

When an institutional patient has no locatable agent, guardian, or earlier-listed default surrogate despite best efforts, § 75A-9-111(6) permits the responsible professional to designate a willing independent physician only after obtaining medical-ethics-group consensus, informing the patient of the designation and objection right, and documenting the physician's identity. The appointment ends if an earlier-listed willing surrogate is found or the patient leaves the institution.

Common questions

Are a child and parent in separate ranks? No. Section 75A-9-111(2)(c) places an adult child and a parent in the same class; § 75A-9-112 governs disagreement within that class.

Can a patient reject a proposed surrogate? Section 75A-9-113(1) recognizes a clear verbal or nonverbal disqualification even if the patient lacks capacity to create an advance directive.

Does a default surrogate need court approval for each decision? Section 75A-9-111(5) says a default surrogate's decision is effective without judicial approval.

Statutes and sources

Verbatim official excerpts, section URLs, and access dates are in the source fields above.