Living with Chronic Pain

Differences Between a Patient Advocate and a Substitute Decision Maker (SDM)


When needing support with medical or health care decisions, a patient advocate and substitute decision maker (SDM) can be beneficial. Both protect the best interest of individuals, while supporting their health care needs. However, there are several differences between a patient advocate and an SDM.

The primary difference between an SDM and a patient advocate is who makes the health care decisions. An SDM makes health care decisions on an individuals’ behalf in the event they become unable or incompetent to make their own decisions. A patient advocate provides support and guidance with health care decisions; however, the individual still makes their own decisions.

An SDM is usually a family member or friend. Although a patient advocate can also be a family member or friend, oftentimes, they are a hospital employee, professional patient advocate, or someone with knowledge and experience within the health care system. A person can also be their own patient advocate.

Appointing an SDM usually requires legal documentation, such as a representation agreement, whereas working with a patient advocate is less formal. This includes asking to speak with a hospital’s patient advocate or signing up for the services of a professional patient advocate.

In health care settings, patient advocates and substitute decision makers have different but important roles. An individual may benefit from having both.

Additional source: A Place for Mom

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