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It is true that in the state of Maryland your spouse will be your default health care agent. But you should still have a conversation about your care wishes and officially name your agent and select an alternate agent. Talking with loved ones about your wishes will help lessen conflicts about the care decisions your spouse is making because everyone will be aware of your wishes. There may also be situations where your spouse is also unable to communicate (for example, if you were both involved in the same trauma or accident). Having named your health care agent (and your alternate proxies) will help ensure your care decisions are known and followed.