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if you were unable to speak for yourself do you know who would make medical decisions for you through what is known as a medical power of attorney you can specify who you want your medical decision maker to be in case of a situation where you cannot make your own decisions so this is the person who makes tough choices on your behalf regarding your health care its literally who do you trust with your life what a lot of people do not realize though is that if you have not completed a medical power of attorney then the state of texas determines who that person is your spouse is first in line and then your reasonably available adult children in third place are your parents if you have none of these then medical decisions would then pass to your nearest living relative lets discuss the first two your spouse and your reasonably available adult children regarding your spouse all that matters in this context is who is your spouse who is your legal spouse even if youre separated if you do no