When is a proxy decision-maker used for informed consent?

• A. When the patient is a minor
• B. When the patient lacks decision-making capacity and has designated a healthcare proxy or guardian.
• C. Only if the patient requests
• D. Never; consent must be given by patient

Answer: (B)

When a patient cannot understand or weigh medical information and communicate a choice, someone else must step in to decide. A proxy decision-maker is used when there is a lack of decision-making capacity and the patient has previously designated a healthcare proxy or guardian. That designation gives the proxy the authority to consent to treatment on the patient’s behalf, ideally following the patient’s known wishes or, if those aren’t known, acting in the patient’s best interests. Minor patients typically require a parent or legal guardian to consent, so a proxy is not the default here. The idea is to respect autonomy by honoring a pre-arranged plan for consent in situations where the patient can’t participate themselves.