Under the Uniform Health Care Decisions Act, if a patient is incapacitated and lacks an advance directive, who is first in the hierarchy to make medical decisions?

• A. Adult child
• B. Spouse
• C. Parent
• D. Adult sibling

Answer: (B)

When a patient is incapacitated and has no advance directive, the medical decision-maker is chosen from a legally defined priority list. The top choice on that list is the spouse, because the spouse is considered the closest partner who is most likely to know and reflect the patient’s values and preferences. If there is no spouse, the next in line would be an adult child, then a parent, then an adult sibling. The goal is to apply substituted judgment to honor what the patient would want, or, if unknown, to make decisions in the patient’s best interests.