By Bob Katzen

Would create a process for handling the care of incapacitated patients who don’t have a health care proxy. The measure would allow attending physicians to appoint surrogate decision makers and identifies several candidates for that role, including the incapacitated patient’s spouse, unless legally separated, parent, adult child or adult sibling.

Under current law, Massachusetts health care providers must go through the difficult process of seeking a judicially appointed medical guardian before even routine decisions about care can be made. Then, after a medical guardian is appointed, some decisions, including those related to transfers to nursing facilities, require additional judicial approval. These cumbersome processes are a disservice to incapacitated patients, whose care can be delayed by weeks.

A surrogate would not be empowered to make decisions about transferring the patient to an inpatient mental health facility nor be able to make any “extraordinary” decisions about life support, sterilization and abortion. Those decisions would continue to be determined by a court.

“Massachusetts is one of only four states without a statute allowing for the appointment of a health care surrogate when an incapacitated patient does not have a designated proxy,” said sponsor Sen. Cindy Cream. “[The bill] would create a more practical process for making medical decisions in such cases, while preserving important safeguards. Certain decisions would still require additional judicial approval, ensuring continued oversight. The bill strikes a careful balance by allowing timely care decisions to be made in the patient’s best interest, while respecting their rights and aligning as closely as possible with their known values and wishes.”