Acting as the substitute decision-maker (SDM) for a loved one can be an incredibly challenging and distressing job, practically, emotionally, and ethically. Most SDMs are not aware that our healthcare legislation contains decision-making principles which they are expected to follow when giving or refusing consent. And even once they are made aware of these principles, many SDMs continue to face challenges in their role. In this session, we'll look at the complexities that can arise even for thoroughly well-informed and conscientious SDMs, and we'll discuss strategies for working with these individuals as they make decisions for our patients.