Question: My grandmother recently had a stroke and went into the hospital. She had a living will from the early 1990s, but her agents had since died. The hospital told us that someone in the family should be the surrogate to make health care decisions for her. We have never heard about a surrogate. What is it?

Answer: Since her agents have died, the hospital needed to have someone make health care decisions for her, and in 1999 the law added a surrogacy provision which allows “;interested persons”; (family members and close friends) to decide on a person who will make health care decisions for a person without an Advance Health Care Directive. That person can make all health care decisions for the person who is incapacitated, except for end-of-life decisions.

End-of-life decisions need to be made in consultation with the treating physicians. It would be recommended that whoever is appointed as the surrogate use her decisions in the earlier living-will document to make sure that they are in compliance with her wishes. If the “;interested persons”; cannot agree on a person to make health care decisions for your grandmother, then those disagreeing might need to petition the court to make the decision for them.

It is important to note that in 1999 the law also changed living wills to Advance Health Care Directives, which allow a person who has capacity to make decisions about her health care decisions and to make end-of-life decisions. This doesn't mean that her old living will is no longer valid, but it likely does not provide more recent provisions for tube-feeding and other life-ending decisions.