Bill defines who can make health decisions for you

A bill presented Wednesday before a Missouri House committee would create a default list of individuals who can consent for the health care of another individual.

“If you are hurt today, even if you don’t have a will, you assume your spouse will make your decisions,” said Rep. Bill White, the bill’s sponsor. “There’s no law for that (in Missouri).”

He said his proposed bill allows individuals to consent for anything, not only end of life.

“You’ve been injured and someone needs to give consent for a procedure,” said White, R-Joplin. “The procedure has risks for the patient’s health care and someone has to make that call.”

The bill gives nine categories of individuals the authority to consent if a patient is unable. They are:

• A court-appointed guardian.

• An attorney-in-fact appointed in a durable power of attorney.

• An individual appointed by law.

• A spouse, unless the spouse and the patient are separated or have a pending divorce.

• A parent or adult child.

• An adult sibling, grandparent or adult grandchild.

• Any other relative by blood or marriage who reasonably is believed by the health care professional to have a close personal relationship with the patient.

• Any nonrelative who reasonably is believed by the health care professional to have a close personal relationship with the patient.

• A person given authority to make health care decisions for the patient by another statutory provision.

White said a health care professional will start with the first category and go through the list until someone able to give consent is found.

Sarah Wilson, executive director of Hospice Compassus in Jefferson City, said her organization supports the bill because health care decisions like this are made every day.

“Right now, across Missouri, these decisions are being made in every facility with that individual agency’s pecking order on how that decision will be made,” she said. “An agency may have a different pecking order than what we may have.”

Larry Roback, with LeadingAge Missouri, said the bill helps residents who are no longer competent make decisions.

“In some cases, it’s difficult for our folks to know what to do next,” he said.

Tyler McClay, general counsel for the Missouri Catholic Conference, said his primary concern with the bill is that it doesn’t specify what decisions an individual can and cannot provide consent.

“I’m not disputing there may be a need for this,” he said. “The concern is we can’t do that without addressing what you can and cannot do if you’re that person appointed.”

Susan Klein, legislative liaison with Missouri Right to Life, said there needs to be more clarification in the bill’s language regarding life preserving treatment for a pregnant patient.


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