Massachusetts amends laws for surrogate decision making for incapacitated persons

House Bill 1874, introduced in Massachusetts on April 18, 2025, aims to streamline the process of surrogate decision-making for incapacitated individuals regarding medical treatment. This legislation amends Chapter 201D of the General Laws, specifically adding a new section that clarifies the roles and responsibilities of surrogate decision-makers.

The primary purpose of House Bill 1874 is to allow designated surrogates to make medical decisions for incapacitated persons without the need for court intervention, provided certain conditions are met. The bill specifies that it applies only to individuals who do not have an active Health Care Proxy or a Medical Order for Life-Sustaining Treatment (MOLST). In such cases, surrogates can make decisions about medical treatment and admissions to nursing facilities, but they are prohibited from committing individuals to inpatient mental health facilities.

Key provisions of the bill include a clear hierarchy for surrogate decision-makers, ensuring that decisions are made in consultation with the individual’s family or other designated persons. The legislation also maintains the validity of court-appointed guardianship as a means of establishing a medical decision-maker, thereby preserving existing legal frameworks.

Debate surrounding House Bill 1874 has focused on the balance between facilitating timely medical decisions and protecting the rights of incapacitated individuals. Advocates argue that the bill will reduce delays in care and alleviate burdens on families, while opponents express concerns about potential misuse of surrogate authority and the need for safeguards to protect vulnerable populations.

The implications of this bill are significant, as it addresses a critical gap in the current legal framework for medical decision-making. By simplifying the process, it could lead to more efficient healthcare delivery for incapacitated individuals, potentially reducing hospital stays and associated costs. However, the bill's success will depend on the implementation of adequate oversight mechanisms to ensure that surrogate decisions are made in the best interest of the patients.

As House Bill 1874 moves through the legislative process, stakeholders from healthcare, legal, and advocacy sectors will be closely monitoring its progress and potential impact on the rights and care of incapacitated individuals in Massachusetts.