Surrogate Decision-Making Committee Services (2024)

The Surrogate Decision-Making Committee (SDMC) program is an alternative to the court system and is authorized to provide consent for non-emergency major medical treatment and end-of-life care decisions for people who qualify. Our program consists of volunteer panels thatmake the decision, providing for quicker, more accessible, cost-free, and personalized decision on behalf of individuals receiving services.

What decisions can be made?

Medical, surgical, dental, or diagnostic interventions or procedures which involve:

• The use of a general anesthetic
• Any significant invasion of bodily integrity requiring an incision or producing substantial pain, discomfort, debilitation, or having a significant recovery period
• Significant risk (e.g., colonoscopies, endoscopies, MRIs, CT Scans with contrast)
• Chemotherapy
• Hospice
• Withdrawal or withholding of life sustaining treatment for persons with an intellectual or developmental disability
• Any other treatment or procedure for which informed consent is required by law

What treatment is excluded by law from the SDMC program?

• Routine diagnosis or treatment including the administration of routine medications
• Dental care performed under a local anesthetic
• Emergency medical treatment
• Electroconvulsive therapy (ECT)
• Withdrawal or discontinuation of life-sustaining medical treatment except as provided in the Health Care Decisions Act for persons with an intellectual or developmental disability
• Sterilization
• Termination of pregnancy

If you would like to learn more about the medical decisions that are covered under SDMC, eligibility criteria, and which forms to complete when requesting a decision, please review the SDMC Services Video.

SDMC considers major medical treatment decisions and end of life care decisions for certain individuals who are unable to provide informed consent and have no authorized, willing, and available surrogate to act on their behalf.

Who is eligible?

Major medical

Individuals believed to be incapable of providing informed consent,have no surrogateauthorized to act on their behalf, and:

• Currently reside or have formerly resided in a residential program operated, licensed, approved, or funded by the Office for People With Developmental Disabilities (OPWDD), the Office of Mental Health (OMH), or theOffice of Addiction Services and Supports(OASAS); or
• Currently or previously receive(d) individual support,case management, family care or day programsapproved or funded by OPWDD.

End of life care decisions

SDMC was granted jurisdiction to provide end of life care decisions for individuals with intellectual or developmental disabilities through an amendment to the Health Care Decisions Act in 2008.

When is a person considered to be incapable of providing consent?

If an individual is unable to assess the risks, benefits, and alternatives to a proposed medical treatment, including the risks of non-treatment, they are therefore unable to make an informed decision to consent or refuse such treatment.

Who serves on SDMC panels?

A panel is made up of volunteers appointedby the Justice Center who serve their home communities throughout New York State. A hearing panel must consist of at least three, and no more than fourmembers.

The panels are made up ofone member from each of the following categories:

• NYS Licensed Health Care Professional (e.g., physician, nurse, clinical social worker)
• NYS Attorney
• Former patients or family members of individuals with mental disabilities
• Advocate for persons with mental disabilities (e.g., persons with recognized expertise or demonstrated interest in the care and treatment or individuals with behavioral health or developmental disabilities)

What determinations must the SDMC panels make?

Panels will make as many as three decisions:

1. Determination of the individual’s ability to consent to or refuse the proposed major medical treatment decision.
2. Determination of whether there is an authorized surrogate who is willing and available to consent to or refuse the proposed major medical procedure on behalf of the individual.
3. Determination of whether the proposed major medical treatment decision is in the best interest of the patient.

The panel makesthese decisions in this order to protect the individual’s rights. In all cases, the individual will be seen by the panel or one of its membersbefore a decision is made.

What is an SDMC hearing like?

The SDMC hearing is a quasi-judicial hearing, with procedures that are more informal than a court/judicial trial. The hearing will take place at a location convenient to the individual in need of a decision, usually in a community-based setting. To understand the SDMC hearing process, please view the SDMC Mock Hearing video.