It is the responsibility of the interdisciplinary team (IDT) to identify and designate actively involved family members who have decision-making capacity and are willing to become a surrogate decision maker (SDM).
Actively involved family members must be contacted in the following descending order:
- Adult child
- Parent or stepparent
- Other adult relative (grandparent, aunt, uncle, niece, nephew or cousin)
An SDM should know their family member’s preferences, values and beliefs. There can be only one SDM at a time. If more than one family member wants to be the SDM, then the relatives who decide not to be the SDM must sign a waiver and consent form stating they agree with the person who was chosen to be the SDM.
In the event of a dispute between two or more family members concerning who should be the SDM, the dispute can only be resolved by a court of law.
An SDM is authorized to make the following treatment decisions:
- Major medical treatment
- Major dental treatment
- Release of records and other information relevant to the treatment or condition necessary to facilitate the process of obtaining consent for treatment
- Consent decisions which the IDT agrees involve risk to the person’s protection and rights that are not specifically reserved to an SDM or surrogate consent committee (SCC)
An SDM is not authorized to consent to:
- The administration of psychoactive medication
- Use of a highly restrictive behavior procedure
These treatment decisions are reserved for a SCC.