Who Are "Unrepresented" Patients and What Count as "Important" Medical Decisions for Them?

Unrepresented patients are hospital patients who lack decision-making capacity but have no advance directive and no one to serve as a legally authorized surrogate. An important first step in efforts to change the law and develop organizational policies that help respond to these patients' needs is determining which patients should be considered unrepresented and which aspects of hospital care should receive attention. This article proposes working definitions of patient and medical decisions based on the work of one statewide initiative, the Unrepresented Patients Project for Illinois.