Accepted surrogates: None Authorized proxies only Proxy or spouses only

1. Accepted surrogates: None Authorized proxies only Proxy or spouses only Proxy, spouses, or parents only Proxy, any family or friend Figure 1S: Geographic variability in Institutions Review Board (IRB) acceptance of surrogates for research. Number of IRBs surveyed is embedded within each state. Pie chart indicates the IRB responses on the limits to acceptable research surrogates. In states without a pie chart, surrogate consent can be accepted from healthcare proxies or family or friends in the absence of a health care proxy. To ensure privacy, the results of states or territories with 10 or fewer IRBs registered with Office of Humans and Research Protection are combined and presented together. Western states include Alaska, Montana, New Mexico, North Dakota, Oregon, Utah, and Wyoming. Eastern areas include Delaware, District of Columbia, Missouri, Puerto Rico, Vermont, and West Virginia.