Do Oregon and North Dakota Healthcare Surrogates Perform Better?

In most states an individual can appoint a healthcare agent not only without the consent of the agent but also without even discussing the appointment with the agent.  In fact, many healthcare surrogates fulfill the role of substitute decision maker with neither an understanding of the role nor an understanding of the patient's wishes.



But in Oregon and North Dakota healthcare agents must accept the appointment in writing.  (Ore. Rev. Stat. 127.525; N.D. Code 23-06.5-06)  Ideally this requirement would apprise the agent of their duties.  And it would prompt a discussion between the principal and agent.  



Robust evidence shows that surrogates perform rather poorly in terms of making the same treatment decisions that patients would make for themselves.  I wonder whether Oregon and North Dakota surrogates perform better.