South Carolina Surrogate Decision Maker Lookup

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

South Carolina 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 South Carolina

  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.

South Carolina's default surrogate order

  1. Court-appointed guardian (If the decision is within the scope of the guardianship)
  2. Attorney-in-fact under a durable power of attorney (If the decision is within the agent's authority)
  3. Spouse (Not if separated under a pendente lite order, signed marital settlement agreement or separate-maintenance order)
  4. An adult child, or a majority of reasonably available adult children
  5. A parent
  6. An adult sibling, or a majority of reasonably available adult siblings
  7. A grandparent, or a majority of reasonably available grandparents
  8. Another adult relative by blood or marriage with a close personal relationship (The health care professional must reasonably believe the relationship is close; majority if several)
  9. A person given health care authority by another statute
  10. Someone with an established relationship who can reliably convey the patient's wishes (Not a paid caregiver or provider; only after a good-faith search; must sign a notarized acknowledgement form)
What it covers
Lists who may make health care decisions for a patient 16 or older who is unable to consent. Health care is defined broadly and includes placement in or removal from a care facility.
If more than one person is in the same group
Adult children, siblings, grandparents and other relatives act by majority of those reasonably available. If people of equal priority disagree, an interested person may ask the probate court to decide.
Who decides the person cannot decide
Two licensed physicians who each examined the patient must certify inability to consent, with a limited emergency exception.
Limits
  • A person the patient did not want involved in their care (known to the provider) loses priority.
  • The chapter does not authorize care the provider knows is contrary to the patient's clear prior instructions.
  • It does not apply when incapacity is temporary and waiting would not significantly harm the patient.
  • The decision follows the patient's wishes if known, otherwise best interest.

Source: S.C. Code Ann. 44-66-30 · Checked October 26, 2026

Next steps

Who decides in South Carolina without a power of attorney?

South Carolina's default surrogate law (S.C. Code Ann. 44-66-30) covers health-care decisions generally. Without a health-care agent or guardian, the first person in line under the statute is: Spouse (not if separated under a pendente lite order, signed marital settlement agreement or separate-maintenance order).

South Carolina's default surrogate law in full

South Carolina's default surrogate order

  1. Court-appointed guardian (If the decision is within the scope of the guardianship)
  2. Attorney-in-fact under a durable power of attorney (If the decision is within the agent's authority)
  3. Spouse (Not if separated under a pendente lite order, signed marital settlement agreement or separate-maintenance order)
  4. An adult child, or a majority of reasonably available adult children
  5. A parent
  6. An adult sibling, or a majority of reasonably available adult siblings
  7. A grandparent, or a majority of reasonably available grandparents
  8. Another adult relative by blood or marriage with a close personal relationship (The health care professional must reasonably believe the relationship is close; majority if several)
  9. A person given health care authority by another statute
  10. Someone with an established relationship who can reliably convey the patient's wishes (Not a paid caregiver or provider; only after a good-faith search; must sign a notarized acknowledgement form)
What it covers
Lists who may make health care decisions for a patient 16 or older who is unable to consent. Health care is defined broadly and includes placement in or removal from a care facility.
If more than one person is in the same group
Adult children, siblings, grandparents and other relatives act by majority of those reasonably available. If people of equal priority disagree, an interested person may ask the probate court to decide.
Who decides the person cannot decide
Two licensed physicians who each examined the patient must certify inability to consent, with a limited emergency exception.
Limits
  • A person the patient did not want involved in their care (known to the provider) loses priority.
  • The chapter does not authorize care the provider knows is contrary to the patient's clear prior instructions.
  • It does not apply when incapacity is temporary and waiting would not significantly harm the patient.
  • The decision follows the patient's wishes if known, otherwise best interest.

Source: S.C. Code Ann. 44-66-30 · 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 South Carolina if there is no power of attorney?

South Carolina's default surrogate law (S.C. Code Ann. 44-66-30) covers health-care decisions generally. Without a health-care agent or guardian, the first person in line under the statute is: Spouse (not if separated under a pendente lite order, signed marital settlement agreement or separate-maintenance order). The full order, tie rule and limits are in S.C. Code Ann. 44-66-30.

Does next of kin in South Carolina have authority over money?

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

Sources

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

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