1. You want to choose a person who is comfortable making decisions on your behalf even if your wishes differ from their own. The advance directive is about you and your wishes, not about the surrogate.
  2. It takes a lot of emotional strength to help carry out choices at end-of-life (EOL), especially when they involve a loved one. Keep in mind that some people might feel guilt or second-guess their role as a surrogate. They will have to put those feelings aside to do what’s best for you.
  3. Choose a strong communicator who can gently but effectively get the point across to medical staff and your family.
  4. Your ideal surrogate should have an open mind and be a good listener.
  5. Your surrogate should be deliberate and assertive about your medical care, able to communicate what you want in an emergency or EOL.
  6. Choose someone who will stand up for you and your wishes. This person won’t be intimidated, bullied, or guilted into acting. They won’t cave under pressure or back down but will challenge treatment options they feel are contrary to yours.
  7. Choose a person who isn’t afraid to speak to authority figures or ask medical staff questions. A surrogate isn’t expected to know everything. There are experts available to lay out the options and give your surrogate guidance.
  8. Ideally, your surrogate will research your condition and keep asking questions until he/she understands treatment requests from staff and how they affect your wishes.
  9. The surrogate should feel comfortable seeking help if he/she feels ignored, over-ruled, or out-numbered. Support can come from a hospital ethics committee, legal/compliance department, or Final Exit’s Surrogate Consultant. My contact info is at the bottom of this page.
  10. Your surrogate needs to be organized and able to help medical staff prioritize your needs according to your wishes.
  11. You want a person who will remain calm under pressure or in a quickly changing or emergent situation.

Your surrogate needs to be ready, willing, and able to act when you become incapacitated. Think twice about choosing someone who might not be able to answer an emergency call and come right away. After you choose the perfect surrogate, chose an alternate in case number one is not available for whatever reason.