Maryland Surrogate Decision Maker Lookup

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

Maryland law checked against official sources on October 26, 2026.

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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 Maryland

  1. With no agent and no guardian, this state's default surrogate law lets a family member or other listed person make health-care decisions, in the order below.
  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.

Maryland's default surrogate order

  1. Guardian (If one has been appointed)
  2. Spouse or domestic partner (Not if under a protective order protecting the patient, or with a separation agreement or divorce filing)
  3. An adult child
  4. A parent
  5. An adult brother or sister
  6. A friend or other relative who gives the attending physician an affidavit (Must be competent and show regular contact and familiarity)
What it covers
Listed persons may make health care decisions for someone certified incapable of an informed decision who has no available health care agent, except sterilization and mental-disorder treatment.
If more than one person is in the same group
In a hospital, a disagreement among equal-priority persons goes to the patient care advisory committee. Outside a hospital, life-sustaining procedures cannot be withheld or withdrawn unless everyone in the class agrees.
Who decides the person cannot decide
The person must have been certified as incapable of making an informed decision.
Limits
  • A surrogate may not authorize sterilization or treatment for a mental disorder.
  • A lower class may be used only if everyone in the next higher class is unavailable.
  • The friend or relative must present an affidavit showing regular contact.

Source: Md. Code, Health-Gen. 5-605 · Checked October 26, 2026

Less certain: Maryland's official statute page shows no amendment history, so the date of the last change to this list is not established.

Next steps

Who decides in Maryland without a power of attorney?

Maryland's default surrogate law (Md. Code, Health-Gen. 5-605) covers health-care decisions generally. Without a health-care agent or guardian, the first person in line under the statute is: Spouse or domestic partner (not if under a protective order protecting the patient, or with a separation agreement or divorce filing).

Maryland's default surrogate law in full

Maryland's default surrogate order

  1. Guardian (If one has been appointed)
  2. Spouse or domestic partner (Not if under a protective order protecting the patient, or with a separation agreement or divorce filing)
  3. An adult child
  4. A parent
  5. An adult brother or sister
  6. A friend or other relative who gives the attending physician an affidavit (Must be competent and show regular contact and familiarity)
What it covers
Listed persons may make health care decisions for someone certified incapable of an informed decision who has no available health care agent, except sterilization and mental-disorder treatment.
If more than one person is in the same group
In a hospital, a disagreement among equal-priority persons goes to the patient care advisory committee. Outside a hospital, life-sustaining procedures cannot be withheld or withdrawn unless everyone in the class agrees.
Who decides the person cannot decide
The person must have been certified as incapable of making an informed decision.
Limits
  • A surrogate may not authorize sterilization or treatment for a mental disorder.
  • A lower class may be used only if everyone in the next higher class is unavailable.
  • The friend or relative must present an affidavit showing regular contact.

Source: Md. Code, Health-Gen. 5-605 · Checked October 26, 2026

Less certain: Maryland's official statute page shows no amendment history, so the date of the last change to this list is not established.

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 Maryland if there is no power of attorney?

Maryland's default surrogate law (Md. Code, Health-Gen. 5-605) covers health-care decisions generally. Without a health-care agent or guardian, the first person in line under the statute is: Spouse or domestic partner (not if under a protective order protecting the patient, or with a separation agreement or divorce filing). The full order, tie rule and limits are in Md. Code, Health-Gen. 5-605.

Does next of kin in Maryland have authority over money?

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

Sources

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

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