Who Makes Your Medical Decisions for You When You Can’t?

Estate planning in La Jolla, University City – UTC, and San Diego

By Amy Hsiao

Sep 19

What happens if you don’t name anyone to make healthcare decisions on your behalf when you’re not in a position to make them yourself? Today Dr. Bob Uslander joins me again to discuss the issue at hand. 

If you don’t do any prior planning or name someone to make your healthcare decisions for you, then the state will decide for you. To make that decision, the state goes down the line of your family: ​If applicable, that power is given to your spouse, your children, your next of kin, or whoever is closest to you. 

The problem with the state making that decision for you is that the state knows nothing about you and your family. Especially in California, there are many blended families with different dynamics;​ it could be that the person who is, per the state, closest to you might not be the one you’d personally want making decisions for you. 

Further to that, the paperwork needed by the state to make the arrangement can take a long time to process. We’ve had a client whose mother was in the hospital, and the client spent three or four months trying to file paperwork in court to access her mother’s medical records—all because the mother didn’t have a nomination. 

That’s just the legal perspective, however… what’s the medical perspective? 

According to Dr. Uslander, in real practice,​ ​when someone who is unable to effectively communicate comes into the emergency room and has no documentation of what they would or wouldn’t want, the default position is a full-court press: ​Everything is done regardless of how much it may go against the principals of that person. ​So if you’re a 95-year-old living in a nursing home with a horrible quality of life and then, say, you stop breathing, you’ll be resuscitated when you come to the emergency room, even if that is something that you wouldn’t want necessarily. 

The default position isn’t necessarily the best one. If there is someone present who can make your decisions on your behalf and whom you trust, that’s by far the best scenario. Sometimes, medical decisions need to be made quickly, so​ if you don’t have someone named, the state’s months-long process could leave you sitting in the intensive care unit in a condition that might be appalling to you and everyone else, but no one could legally do anything about it​. 

That’s why we encourage you to be proactive and get your affairs set up now. If we can be of service and help you understand the nuances of this whole process, it would be our pleasure if you reached out to us. We want to help ensure that your wishes are documented and communicated to the proper channels. And if you do reach out to us about this topic, we’ll send you a gift certificate as an incentive to get this important planning done sooner than later.