Iowa Surrogate Decision Maker Lookup

Who can make medical and money decisions for an adult in Iowa who cannot decide: an agent, a guardian, or Iowa's default surrogate order. Runs in your browser; nothing is stored.

Iowa law 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.

What needs deciding?
Can the person understand this decision and make it, with help if needed?
Which of these exist? (tick all that apply)

Who has authority in Iowa

  1. With no agent and no guardian, this state's default surrogate law applies only to some decisions or settings (see the scope below). Outside that scope, someone may need a court appointment.
  2. If nobody is available or the family disagrees, a court can appoint a guardian. That is slower and costs more than documents signed in advance.

Iowa's default surrogate order

  1. Attorney in fact under a chapter 144B durable power of attorney for health care (If the designation is in writing and complies with chapter 144B)
  2. Guardian of the person (Court approval is required)
  3. Spouse
  4. An adult child, or a majority of reasonably available adult children
  5. A parent, or both parents if both are reasonably available
  6. An adult sibling
What it covers
Covers only withholding or withdrawing life-sustaining procedures from a patient in a terminal condition who cannot communicate and made no declaration, by written agreement with the attending physician.
If more than one person is in the same group
Adult children act by majority of those reasonably available; no rule is stated for other classes.
Who decides the person cannot decide
Patient must be in a terminal condition and comatose, incompetent or otherwise unable to communicate; this section does not name who finds incapacity.
Limits
  • A witness must be present at the consultation when the decision is made.
  • Does not apply to a patient known to be pregnant with a fetus that could develop to live birth.
  • The decision-maker is guided by the patient's express or implied intentions.

Source: Iowa Code 144A.7 · Checked October 26, 2026

Next steps

Who decides in Iowa without a power of attorney?

Iowa's default surrogate law (Iowa Code 144A.7) covers only some decisions or settings. Without a health-care agent or guardian, the first person in line under the statute is: Spouse.

Iowa's default surrogate law in full

Iowa's default surrogate order

  1. Attorney in fact under a chapter 144B durable power of attorney for health care (If the designation is in writing and complies with chapter 144B)
  2. Guardian of the person (Court approval is required)
  3. Spouse
  4. An adult child, or a majority of reasonably available adult children
  5. A parent, or both parents if both are reasonably available
  6. An adult sibling
What it covers
Covers only withholding or withdrawing life-sustaining procedures from a patient in a terminal condition who cannot communicate and made no declaration, by written agreement with the attending physician.
If more than one person is in the same group
Adult children act by majority of those reasonably available; no rule is stated for other classes.
Who decides the person cannot decide
Patient must be in a terminal condition and comatose, incompetent or otherwise unable to communicate; this section does not name who finds incapacity.
Limits
  • A witness must be present at the consultation when the decision is made.
  • Does not apply to a patient known to be pregnant with a fetus that could develop to live birth.
  • The decision-maker is guided by the patient's express or implied intentions.

Source: Iowa Code 144A.7 · Checked October 26, 2026

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.

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 in Iowa if there is no power of attorney?

Iowa's default surrogate law (Iowa Code 144A.7) covers only some decisions or settings. Without a health-care agent or guardian, the first person in line under the statute is: Spouse. The full order, tie rule and limits are in Iowa Code 144A.7.

Does next of kin in Iowa have authority over money?

No default surrogate law covers money. In Iowa, as everywhere, managing another adult's accounts or property takes a durable power of attorney or a court appointment.

Sources

Iowa law checked against the official text on October 26, 2026.

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