Surrogate Decision Maker Lookup
Who can make medical and money decisions for an adult who cannot decide, in all 50 states and DC: the agent under a power of attorney, a guardian, or the state's default surrogate list. Runs in your browser; nothing is stored.
State laws checked against official sources on October 26, 2026.
Everything you enter stays in your browser. Nothing is sent, saved, or added to the page address. No names are asked for.
Who decides when there is no power of attorney?
Of the 50 states and DC, 34 have a default surrogate law that lets listed family members make health-care decisions generally. In 9 more, the law reaches only some decisions or settings, such as withdrawing life support or care in a hospital. In 8 we found no general default surrogate statute.
How authority works when someone cannot decide
An adult who can understand a decision makes it, even when family disagrees. Authority passes to someone else only when the person cannot decide, and the source of that authority matters.
The strongest source is a document the person signed while able: a health-care power of attorney or advance directive naming an agent for medical decisions, and a durable power of attorney for money and property. A court appointment (a guardian, or in some states a conservator for money) comes next, and it is slower and more expensive.
For health-care decisions only, most states also have a default surrogate law, sometimes called a family consent law. It lists who may decide when there is no agent and no guardian, usually starting with a spouse, then adult children, then parents and siblings. Doctors and hospitals apply it at the bedside.
There is no "next of kin" list for money
Default surrogate laws cover health care, not bank accounts, bills or property. Being a spouse, child or next of kin does not by itself let you sign checks or sell a house for another adult. Without a durable power of attorney, managing someone else's money usually needs a court appointment.
Federal benefits follow their own rules. Social Security says a power of attorney, an authorized representative or a joint account is not the same as being a payee; SSA appoints a representative payee. VA appoints a fiduciary for a beneficiary who cannot manage VA benefits.
Default surrogate laws in every state
The tables below list each state's default surrogate statute, what it covers, and who is first in line when there is no health-care agent or guardian. Select a state for the full order, the tie rule, the limits and the source.
| State | Default surrogate law | Covers | First in line (without an agent or guardian) |
|---|---|---|---|
| Connecticut | None found | - | - |
| Maine | 18-C M.R.S. 5-806 | Health-care decisions generally | Spouse (not if legally separated) |
| Massachusetts | None found | - | - |
| New Hampshire | N.H. Rev. Stat. Ann. 137-J:35 | Health-care decisions generally | Spouse, civil union partner or common law spouse (not if there is a divorce proceeding, separation agreement or restraining order limiting the relationship) |
| New Jersey | None found | - | - |
| New York | N.Y. Pub. Health Law 2994-d | Only in certain settings | Spouse (if not legally separated) or domestic partner (spouse and domestic partner share one class) |
| Pennsylvania | 20 Pa.C.S. 5461 | Health-care decisions generally | Anyone the patient designated in a signed writing or by telling the attending physician or provider; the first relative listed is: Spouse, together with the patient's adult children who are not the spouse's children |
| Rhode Island | None found | - | - |
| Vermont | 18 V.S.A. 9731 | Only specific decisions | No fixed order |
| State | Default surrogate law | Covers | First in line (without an agent or guardian) |
|---|---|---|---|
| Illinois | 755 ILCS 40/25 | Health-care decisions generally | Spouse |
| Indiana | IC 16-36-1-5 | Health-care decisions generally | Spouse (not if legally separated or a dissolution, separation or annulment petition is pending) |
| Iowa | Iowa Code 144A.7 | Life-sustaining treatment only | Spouse |
| Kansas | None found | - | - |
| Michigan | None found | - | - |
| Minnesota | None found | - | - |
| Missouri | RSMo 431.064 | Only specific decisions | Spouse (not if separated, incapable, whereabouts unknown or overseas) |
| Nebraska | Neb. Rev. Stat. 30-604 | Health-care decisions generally | A person the patient named by telling the primary health care provider; the first relative listed is: Spouse |
| North Dakota | N.D. Cent. Code 23-12-13 | Health-care decisions generally | Spouse (must have kept significant contact with the patient) |
| Ohio | Ohio Rev. Code 2133.08 | Life-sustaining treatment only | Spouse (not if a divorce, dissolution, separation or annulment is pending, among other disqualifiers) |
| South Dakota | S.D. Codified Laws 34-12C-3 | Health-care decisions generally | Spouse (if not legally separated) |
| Wisconsin | None found | - | - |
| State | Default surrogate law | Covers | First in line (without an agent or guardian) |
|---|---|---|---|
| Alabama | Ala. Code 22-8A-11 | Life-sustaining treatment only | Spouse (not if legally separated or a party to a divorce proceeding) |
| Arkansas | Ark. Code 20-6-105 | Health-care decisions generally | Someone the patient named by telling the supervising provider (oral or written); the first relative listed is: Spouse |
| Delaware | 16 Del. C. 2512 | Health-care decisions generally | An adult the patient identified to make decisions, outside a power of attorney; the first relative listed is: Spouse or domestic partner |
| District of Columbia | D.C. Code 21-2210 | Health-care decisions generally | Court-appointed intellectual disability advocate (if within the scope of the appointment); the first relative listed is: Spouse or domestic partner |
| Florida | Fla. Stat. 765.401 | Health-care decisions generally | Spouse |
| Georgia | O.C.G.A. 31-9-2 | Health-care decisions generally | Spouse (if no agent is present or available) |
| Kentucky | KRS 311.631 | Health-care decisions generally | Spouse |
| Louisiana | La. R.S. 40:1159.4 | Health-care decisions generally | Spouse not judicially separated |
| Maryland | Md. Code, Health-Gen. 5-605 | Health-care decisions generally | Spouse or domestic partner (not if under a protective order protecting the patient, or with a separation agreement or divorce filing) |
| Mississippi | Miss. Code Ann. 41-41-211 | Health-care decisions generally | Someone the patient named by telling the supervising provider; the first relative listed is: Spouse |
| North Carolina | N.C. Gen. Stat. 90-21.13(c) | Health-care decisions generally | Spouse |
| Oklahoma | 63 Okla. Stat. 3102.4 | Health-care decisions generally | Spouse |
| South Carolina | S.C. Code Ann. 44-66-30 | Health-care decisions generally | Spouse (not if separated under a pendente lite order, signed marital settlement agreement or separate-maintenance order) |
| Tennessee | Tenn. Code Ann. 68-11-1806 | Health-care decisions generally | No fixed order |
| Texas | Tex. Health & Safety Code 313.004 | Only in certain settings | Spouse |
| Virginia | Va. Code Ann. 54.1-2986 | Health-care decisions generally | Spouse (not if a divorce action has been filed and is not final) |
| West Virginia | W. Va. Code 16-30-8 | Health-care decisions generally | Spouse |
| State | Default surrogate law | Covers | First in line (without an agent or guardian) |
|---|---|---|---|
| Alaska | AS 13.52.030 | Health-care decisions generally | Someone the patient named by telling the supervising health care provider (patient designates them personally to the provider); the first relative listed is: Spouse |
| Arizona | A.R.S. 36-3231 | Health-care decisions generally | Spouse (not if legally separated) |
| California | Cal. Prob. Code 4712 | Health-care decisions generally | No fixed order |
| Colorado | C.R.S. 15-18.5-103 | Health-care decisions generally | No fixed order |
| Hawaii | HRS 327E-5 | Health-care decisions generally | No fixed order |
| Idaho | Idaho Code 39-4504 | Health-care decisions generally | Spouse (if married) |
| Montana | Mont. Code Ann. 50-5-1311 (part of 50-5-1301 to 50-5-1311) | Health-care decisions generally | Spouse |
| Nevada | Nev. Rev. Stat. 449A.454 | Life-sustaining treatment only | Spouse |
| New Mexico | N.M. Stat. Ann. 24-7A-5 | Health-care decisions generally | Anyone the patient named by telling the supervising health care provider; the first relative listed is: Spouse |
| Oregon | Or. Rev. Stat. 127.635 | Life-sustaining treatment only | Spouse |
| Utah | Utah Code 75A-9-111 | Health-care decisions generally | An adult the person identified, other than in a power of attorney, to decide; the first relative listed is: Spouse |
| Washington | Wash. Rev. Code 7.70.065 | Health-care decisions generally | Spouse or state registered domestic partner |
| Wyoming | Wyo. Stat. Ann. 35-22-406 | Health-care decisions generally | Anyone the patient named by telling the primary health care provider; the first relative listed is: Spouse |
What this tool does not do
- It reports what each state's statute says. It does not decide whether a person has capacity; the treating doctor does.
- It does not decide disputes between family members or replace a court order. A guardianship order or a power of attorney can change who decides.
- Hospitals, nursing homes and other states' laws can add steps. Ask the facility's patient-relations or legal office which law it applies.
- It is general legal information, not legal advice for your situation.
Frequently Asked Questions
Who makes medical decisions if there is no power of attorney?
In most states a default surrogate law decides, usually starting with a spouse, then adult children, then parents and adult siblings. In 8 of the 50 states and DC we found no general list, and the order and limits differ by state, so check the state page.
Does next of kin have legal authority?
For health care, only where the state default surrogate law names them, and only within its scope. For money and property, next of kin has no automatic authority: it takes a durable power of attorney or a court appointment.
What is the difference between guardianship and power of attorney?
A power of attorney is a document the person signs while able, naming who acts for them. Guardianship is a court appointment made after the person can no longer decide, with court oversight and costs. A valid power of attorney often makes guardianship unnecessary.
Can a surrogate stop life support?
Many states let a surrogate decide about life-sustaining treatment but add conditions, such as a second physician's opinion or a terminal condition. Several states' laws cover only that decision. The state page lists the limits.
Sources
State laws checked against official sources; last checked October 26, 2026.
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