Making a medical decision for yourself is difficult. Making one for a loved one who cannot speak or decide for themselves can feel overwhelming. These moments are often filled with emotion, urgency, and uncertainty, especially when family members do not agree.
But in Florida, the law offers a clear and compassionate answer:
Do not decide based on what you think is best. Decide based on what they would have wanted.
What Is “Substituted Judgment”?
Florida follows the substituted judgment standard for healthcare decisions made on behalf of someone who is incapacitated.
This means: when you are authorized to make a decision for another person, your legal duty is not to choose what seems best to you, but rather to make the choice they would make if they were able.
This standard applies to:
- A healthcare surrogate named in an advance directive.
- An agent under a valid healthcare power of attorney.
- A proxy (e.g., a spouse or adult child) acting under Florida’s statutory hierarchy when no written directive exists.
No matter your title, your responsibility is the same: represent the patient’s values, not your own.
What Florida Law Says
Florida Statutes § 765.205(1)(b) requires that a surrogate must act in accordance with the principal’s instructions and known wishes. Only if those wishes are unknown can you make decisions based on what seems objectively to be in their best interest.
This is not just a recommendation — it is a legal and ethical obligation.
How to Understand Someone’s Wishes
Making decisions using substituted judgment is not guesswork, it is a process of reflection and discovery.
You can look for clues in:
- Past conversations about healthcare or end-of-life care.
- Religious, cultural, or spiritual beliefs.
- How they reacted to the medical situations of friends or family.
- Social values or personal philosophies.
- Emails, texts, or even light-hearted remarks that hint at their views.
The goal is to form an honest picture of how that person thought about life, health, and dignity, and apply that understanding to their current situation.
When There Are No Clues
Only if no prior statements, values, or consistent behavior are available to guide you can you shift to the “best interest” standard.
But Florida law expects you to try — in good faith — to reconstruct what they might have wanted. The “best interest” fallback must be thoughtful and compassionate and should never be the first resort.
Why Substituted Judgment Matters
Florida’s substituted judgment rule exists to:
- Protect vulnerable patients’ autonomy and dignity.
- Prevent unnecessary family conflict.
- Ensure decisions remain deeply personal, not merely clinical, or convenient.
- Encourage advance care planning and open conversations.
Even when someone cannot speak for themselves, their voice and their values still matter.
Give Your Surrogate the Tools to Speak for You
Designating a healthcare surrogate is not just about picking someone you trust; it is about equipping them with the insight and authority they will need to represent your wishes. That is why it is so important to:
- Create clear advance directives.
- Talk openly with your surrogate about your values.
- Put your preferences in writing — early and clearly.
If you have ever had to make these decisions for someone else, you understand how crucial this guidance can be. And, if no one has made these choices for you yet, now is the time.
The foregoing is a brief and general overview of the topic and the need for specific and experienced legal and tax advice is emphasized.
Let Us Help You Plan With Purpose
At Caserta & Spiriti, we help individuals and families throughout Florida document their healthcare wishes with clarity and compassion. We will walk you through:
- Drafting legally valid advance directives.
- Naming a healthcare surrogate.
- Understanding your rights and responsibilities under Florida law.
Contact our office today to protect your voice and give your loved ones the peace of mind they deserve.
