AbstractOn occasion, I am appointed by our local probate court to help make health care decisions for patients who are no longer capable of making these decisions for themselves. I'll visit my client in the hospital and review his or her chart, and I'll have numerous opportunities to talk about the illness and treatment options with attending physicians, residents, and nurses. My phone calls to them will be returned promptly. If doctors arrive at the conclusion that nothing further can be done for the patient, we'll discuss how best to proceed. This end‐of‐life talk never comes as a surprise to me because I will have been included in the team's decision‐making process, in the manner of professionals interacting with another professional.Last fall, I became a family surrogate decision‐maker after my mother was hospitalized over the course of a few months, for a number of reasons, in three hospitals in New York. I assumed I would manage her care as I did my clients’, with a sense of control and involvement in the process, but I quickly learned that I had in fact entered a kind of alternate universe as far as decision‐making was concerned.