The Patient Self-Determination Act of 1990 protects patient autonomy in making medical decisions by giving patients the right to refuse or accept medical treatments recommended by health care providers. However, if a patient is incapacitated due to physical conditions or reduced mental capacity, the legislation allows a surrogate decision maker to be appointed. A surrogate decision maker is an individual (e.g., guardian, spouse, adult child, sibling, grandparent, or close friend) who makes decisions on behalf of a patient who is unable to process the information needed to make decisions, or is unable to communicate his or her wishes to health care providers. Most surrogate decision makers act on behalf of adults who have cognitive impairments due to declining health status, or young children who ...

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