In the hierarchy of decision makers, the top-level role is the ...

• A. Primary proxy
• B. Secondary proxy
• C. Limited proxy
• D. General proxy

Answer: (A)

The top-level role is the primary proxy. This person is designated as the main surrogate to act for the patient when they can’t make medical decisions, carrying the broadest authority to interpret the patient’s values and wishes and to make decisions in line with them. Having a clearly identified primary proxy helps ensure decisions are consistent, timely, and aligned with what the patient would have chosen. If the primary proxy isn’t available, a secondary proxy would step in, while a limited proxy has authority only for specific situations and a general proxy refers to broad authority but not the primary position in the hierarchy.