Should an advocate make decisions for a client?

• A. Avoid making any decision for, or on behalf of, a client
• B. Yes, always decide for them
• C. Only when asked by doctor
• D. Decide and then inform the client later

Answer: (D)

The best approach recognizes that advocates balance respect for a client’s autonomy with the responsibility to act when the client cannot participate in the decision-making process. In situations where a client lacks decision-making capacity or is temporarily unable to engage, an advocate may need to make timely decisions to protect the client’s rights and well-being. However, the advocate should not keep those decisions from the client; informing the client later ensures transparency, preserves trust, and restores participation as soon as the client is able. This approach also aligns with using available directives, substitutes, or legally authorized decision-makers when appropriate, and with documenting reasoning and seeking continued input from the client whenever possible.

Choosing to avoid decision-making entirely would risk harm or deny necessary protections in urgent scenarios, while insisting on the client always deciding alone ignores real capacity limits. Relying solely on the doctor to decide can sidestep the client’s preferences and undermine the advocate’s role in representing the client’s values. And deciding and informing only after the fact would undermine autonomy and trust, so the best practice is to act when needed to safeguard the client, then communicate the decisions to the client as soon as feasible.