The House Judiciary Committee heard testimony on House Bills 4418 and 4419, sponsored by Representative Thompson, which would establish a statutory process for a prioritized next-of-kin or surrogate health-care decision maker when a patient lacks a patient advocate designation (Michigan’s medical power of attorney).

Supporters told the committee the bills are designed to prevent delays in medical decision making that now often force families into court to obtain guardianship when a patient becomes incapacitated without prior paperwork.

Representative Jamie Thompson, sponsor of the bills, told the committee the issue is personal and widespread. “Michigan is not a next of kin state,” Thompson said, describing how she had to spend the last days of her father’s life at his bedside rather than pursuing court guardianship after his health rapidly declined. Thompson said the bills “create a legal framework for a surrogate health care decision maker or next of kin” and would not supersede a durable power of attorney.

Nicole Shannon, an attorney with the Michigan Elder Justice Initiative, described the bills as grounded in national best practices and specific to Michigan drafting needs. “In contrast to over 30 other states, Michigan does not automatically allow next of kin to make these medical decisions,” Shannon said. She explained that when multiple people share top-priority status (for example, several adult children), the proposed law allows those people to select one person to serve as a single spokesperson so clinicians do not need to poll an entire family for routine decisions. Shannon said the surrogate would have the same authority as an agent under the patient-advocate statute in basic matters but that guardianship would remain available if disputes arose.

Genevieve Martin, legislative director and senior policy advisor for Right to Life of Michigan, said the organization has worked on patient-protection laws for decades and supports the bills as a practical safeguard. Martin urged two technical changes: (1) change court language so that a petition to resolve disputes would request appointment of a guardian, temporary guardian, or emergency guardian rather than a “surrogate” because courts do not have an established process to appoint a surrogate; and (2) retain statutory language ensuring medical personnel must obtain consent prior to treatment (Martin identified an enacting-section reference that appeared to repeal MCL provisions and recommended instead amending consent rules to include a surrogate).

Elizabeth Cutter of the Michigan Health & Hospitals Association told the committee the association supports effectuating patient intent and providing clarity to hospitals and clinicians about who may consent when a patient lacks a patient advocate designation.

Witnesses and the sponsor emphasized several limits and safeguards in the bills as presented: the surrogate authority would be temporary and end when the patient regains capacity; the surrogate would not have authority to stop life-sustaining treatment or to consent to certain mental-health treatments beyond what the patient-advocate statute permits; the same incapacity standard used under Michigan’s patient-advocate law (two physicians or one physician and a psychologist) would be used to determine lack of decision-making capacity; and if disputes arise guardianship remains an available remedy.

Committee members had no immediate questions. The clerk read additional letters of support into the record from Emily Henderson, Michelle Roberts of Disability Rights of Michigan, and Richie Farren of HCAM. Committee business concluded and the hearing was adjourned.