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Who Is in Control of Your End-Of-Life Decisions?

By Catherine Hodder, Esq. | Last updated on

You may think you know who can make medical decisions for you if you have a terminal illness or end-stage condition and can't speak for yourself. You may think you have a say in a family member's organ donation or life support options. However, recent news stories show healthcare professionals have inconsistent policies and procedures when consulting next of kin.

A Minnesota family was stunned when they discovered a stranger was making end-of-life medical decisions for their father. The father suffered a seizure causing brain death and was hospitalized at the Hennepin County Medical Center. Although the father listed his brother, Darryl Hatcher, as his medical contact, they did not contact his brother until after his death. In the meantime, Darryl Moore (someone the family does not know) was deciding to take him off of a ventilator.

Also in Minnesota, a family was denied control of their son's medical decisions in favor of an ex-girlfriend. When Jaegger David was dying from a brutal attack, the medical center gave decision-making control to his ex-girlfriend, who was the first to arrive at the hospital. Even though the family supplied birth certificates as proof of their relationship, the medical center followed the ex-girlfriend's instructions prohibiting organ donation, even though the family knew he wished to be an organ donor.

Most Americans don't have any medical power of attorney or advance directives. Less than 30% have completed a living will, and less than 34% designated a health care proxy. A reason for these statistics may be that people assume their family will be able to step in to handle their care if they have a life-threatening illness.

Does Your Family Have a Right to Make Your Medical Decisions?

Not necessarily. Some states have next-of-kin laws establishing who to consult about end-of-life medical decisions, but they don't necessarily list an order or preference. For example, California passed new legislation where if there is no written health care directive or health care proxy, the medical provider can choose from a spouse or domestic partner, a child or grandchild, a parent or sibling, or other relative or close friends. But there is no hierarchy so that a doctor may follow a sibling's advice over a spouse or domestic partner.

Your state may not have laws about consulting next of kin. For example, Minnesota laws do not list who medical professionals should contact for end-of-life decisions.

At best, next of kin laws are inconsistent, and you may not like the result of who medical providers consult about your end-of-life care.

How Do You Control Who Makes Your Medical Decisions?

The best course of action is to write down your wishes in a health care directive and living will. A health care directive lets you name a medical decision-maker for you. This decision-maker is your health care surrogate or proxy. You authorize them to talk to your health care providers, get your medical information and treatment options, and make health care decisions on your behalf. In a living will, you can also detail your wishes for medical treatment, especially if you have a serious illness or terminal condition. If you have feelings about feeding tubes and your quality of life, you should spell out your wishes.

It is especially critical to have advance directives if:

  • There are certain family members you don't want to access your medical records or information about your medical condition.
  • There are certain family members you don't want to make treatment decisions on your behalf.
  • You have specific wishes regarding organ donation.
  • You have specific wishes about life-sustaining treatment and interventions such as artificial nutrition (tube feeding) or hydration.
  • You have specific wishes about nursing homes, palliative care services, or hospice care.
  • You want cardiopulmonary resuscitation (CPR), or a do not resuscitate order (DNR).
  • You don't want your family or loved ones to go through the end-of-life decision-making process, which may cause conflict and stress for them.

However, having a health care directive and living will is not enough. You should alert your medical care staff and caregivers about your advance medical directives and provide them with a copy.

Recent headlines and inconsistent next-of-kin laws serve as stark reminders that you must take charge if you want to make sure your loved ones make your end-of-life decisions. Fortunately, it is easy to create your own advance directives with online resources such as FindLaw Legal Forms and Services.

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