There is a law in New York called the Family Health Care Decisions Act, which passed in 2010. If you don’t have a Health Care Proxy Form completed it designates the person who has the right to make decisions on your behalf. This person is called a surrogate (as opposed to a health care agent which is a person you appoint using the Health Care Proxy Form). The law includes a hierarchy, or order, of who can serve as your surrogate:
The medical team will go down this list until they are able to connect with someone who is willing to make decisions for you. If the surrogate doesn’t know your wishes then the law says there must be an assessment of the patient’s best interests which include: consideration of the dignity and uniqueness of every person; the possibility and extent of preserving the patient’s life; the preservation, improvement or restoration of the patient’s health or functioning; the relief of the patient’s suffering; and any medical condition and such other concerns and values as a reasonable person in the patient’s circumstances would wish to consider.
If they are not able to find someone to serve as your surrogate, then the medical facility (hospital, etc.) or courts will decide your care. As part of this process, they will attempt to identify any documentation of your wishes. Therefore, writing down your wishes, and sharing them with your medical providers, is still important even if you do not have someone you can appoint as your health care agent.