In determining who is legally empowered to make decisions for an incapacitated patient, which option describes the correct authority?

• A. The patient himself or herself
• B. The physician
• C. The patient’s family
• D. The durable power of attorney or designated surrogate

Answer: (D)

When a patient cannot participate in medical decisions, the person who has legal authority to decide is the one the patient has designated to act on their behalf. This is typically the durable power of attorney for healthcare, or a designated surrogate named by the patient or by state law. This designation ensures decisions are made in alignment with the patient’s wishes or best interests, and remains valid even after capacity is lost. A physician does not automatically assume this role, and family members only have decision-making authority if they have been properly designated as a surrogate. If no surrogate or advance directive exists, the decision may fall to a court-appointed guardian according to local law.