How should adults approach healthcare decision-making when a family member lacks decision-making capacity?

• A. Identify a legally authorized decision-maker, respect previously stated wishes, and follow advance directives
• B. Make decisions based on other family members' preferences
• C. Delay decisions until capacity returns
• D. Ignore advance directives

Answer: (A)

When an adult cannot make healthcare decisions, the important step is to identify who is legally authorized to decide for them and to follow any advance directives or previously stated wishes. The person designated as a health care proxy or surrogate should collaborate with the medical team to choose care that reflects the patient’s values, using substituted judgment if their preferences are known or the best interests standard if they are not. If an advance directive exists, its instructions should guide the care provided.

This approach protects the patient’s autonomy and ensures decisions align with what they would have wanted, rather than leaning on others’ preferences or delaying care. Ignoring advance directives or waiting for capacity to return can lead to decisions that don’t match the patient’s values and can cause unnecessary harm or distress.