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In this video, the speaker, a double board-certified intensivist, discusses who makes medical decisions for patients unable to do so, particularly in the context of intensive care units. He emphasizes the importance of having discussions about medical decision-making in advance when possible, especially before placing patients on life support. The speaker explains that if patients cannot communicate, healthcare providers turn to a designated medical power of attorney, which is legal documentation appointing someone to make decisions on their behalf. In many urgent cases, such conversations cannot happen, highlighting the need for preparation regarding medical decision-making.