Who can provide informed consent when a patient lacks decision-making capacity?

• A. The nurse
• B. The physician
• C. A legally authorized surrogate or designated healthcare proxy.
• D. The patient’s family member regardless of status

Answer: (C)

When a patient cannot make or communicate decisions, someone with legal authority must give consent. This is a legally authorized surrogate or designated healthcare proxy, named in an advance directive or appointed by law, who decides based on the patient’s known wishes or, if unknown, the patient’s best interests. The nurse or physician cannot independently authorize treatment for the patient; they provide information and discuss options, but the final consent rests with the legally designated representative. A family member without legal designation does not automatically have the authority to consent, though they may be involved in discussions to inform the surrogate’s decision. In emergencies where no surrogate is available, clinicians may act under implied consent to prevent harm, but this does not replace the need for proper authorization when possible.