Too frequently a relative who is not emotionally close to the patient and who does not know the patient's desires related to health care is authorized to make decisions for the unconscious or incompetent patient, while a non-relative who is intimately involved with the patient and knows the patient's health care desires has no authority to make these decisions. Health care providers must too often stand by helplessly as disinterested or malevolent relatives make these decisions, while caring, competent non-relatives are shut out of the decision-making process. Planning for substitute decision-making can reduce stress and uncertainty for the patient, for the family and for health care providers.