Missouri Surrogate Decision Maker Lookup
Who can make medical and money decisions for an adult in Missouri who cannot decide: an agent, a guardian, or Missouri's default surrogate order. Runs in your browser; nothing is stored.
Missouri law checked against official sources on October 26, 2026.
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Who has authority in Missouri
- 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.
- 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.
Missouri's default surrogate order
- Spouse (Not if separated, incapable, whereabouts unknown or overseas)
- An adult child
- A parent
- A brother or sister
- A relative by blood or marriage
- What it covers
- The only ranked family list found applies to consent for experimental treatment, tests or drugs at a teaching hospital of an accredited medical school. Missouri has no general default-surrogate list.
- Who decides the person cannot decide
- Applies when the adult is incapable of informed consent for the experimental treatment; the section does not say who decides that.
- Limits
- The consenting person cannot go against the patient's expressed permission regarding the treatment.
Source: RSMo 431.064 · Checked October 26, 2026
Less certain: Our search found no general Missouri statute ranking family decision makers, but a full-text search of the Missouri statutes was not run.
Who decides in Missouri without a power of attorney?
Missouri's default surrogate law (RSMo 431.064) covers only some decisions or settings. Without a health-care agent or guardian, the first person in line under the statute is: Spouse (not if separated, incapable, whereabouts unknown or overseas).
Missouri's default surrogate law in full
Missouri's default surrogate order
- Spouse (Not if separated, incapable, whereabouts unknown or overseas)
- An adult child
- A parent
- A brother or sister
- A relative by blood or marriage
- What it covers
- The only ranked family list found applies to consent for experimental treatment, tests or drugs at a teaching hospital of an accredited medical school. Missouri has no general default-surrogate list.
- Who decides the person cannot decide
- Applies when the adult is incapable of informed consent for the experimental treatment; the section does not say who decides that.
- Limits
- The consenting person cannot go against the patient's expressed permission regarding the treatment.
Source: RSMo 431.064 · Checked October 26, 2026
Less certain: Our search found no general Missouri statute ranking family decision makers, but a full-text search of the Missouri statutes was not run.
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 Missouri if there is no power of attorney?
Missouri's default surrogate law (RSMo 431.064) covers only some decisions or settings. Without a health-care agent or guardian, the first person in line under the statute is: Spouse (not if separated, incapable, whereabouts unknown or overseas). The full order, tie rule and limits are in RSMo 431.064.
Does next of kin in Missouri have authority over money?
No default surrogate law covers money. In Missouri, as everywhere, managing another adult's accounts or property takes a durable power of attorney or a court appointment.
Sources
- RSMo 431.064 (Experimental treatment, tests and drugs, consent by third party (431.064))
- Social Security: representative payee FAQ
Missouri law checked against the official text on October 26, 2026.
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