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Committee hears emotional testimony on bills creating next-of-kin medical decision process
Summary
House Bills 4418 and 4419 would establish a prioritized next-of-kin or surrogate decision-maker pathway for people who lack a patient advocate designation, supporters said, while preserving guardianship and encouraging advance directives.
The Michigan House Judiciary Committee on May 22 heard extended testimony supporting House Bills 4418 and 4419, legislation that would create a statutory framework naming prioritized next-of-kin or surrogate medical decision makers when an adult lacks a patient advocate designation or other advance medical directive.
Representative Thompson, one of the sponsors, opened with a personal account of caring for her father and said Michigan’s current rules forced families into the guardianship process in urgent situations. “I did not want to spend the last 3 days of my father's life in court trying to get guardianship of him when I am his daughter,” she told the committee.
Nicole Shannon, an attorney with the Michigan Elder Justice Initiative, testified the bill follows national best practices and would give hospitals a default decision-maker without replacing the Michigan patient advocate designation (the state’s form of medical power of attorney). Shannon said the surrogate would have the same authority as an agent under the basic patient advocate designation, but the bill would not authorize a surrogate to stop life-sustaining treatment or to consent to certain treatments that require higher legal thresholds.
Genevieve Martin, legislative director and senior policy adviser for Right to Life of Michigan, described the bill as a patient-protection measure that provides liability protection for clinicians who need a clear decision maker when no patient advocate form is available. Martin said her research identified similar statutes in many other states and urged the committee to preserve consent safeguards in relevant statutory cross-references.
Witnesses and sponsors emphasized three points: families frequently lack a signed patient advocate form at the time of crisis; a prioritized list of family members and a designated spokesperson when multiple relatives share priority would reduce delays in care and hospital burden; and guardianship would remain an option in cases of dispute or ongoing incapacity. Representative Thompson and other witnesses asked the committee to refine statutory cross-references to avoid unintentionally repealing existing consent requirements referenced in current law.
The committee read in additional support cards from Disability Rights Michigan, the Health Care Association of Michigan (HCAM), and other groups; several organizations asked not to speak. There was no committee vote on the bills at the hearing.
Sponsors and witnesses said the bills are intended to increase patient-centered decision making in acute episodes, reduce unnecessary court filings, and encourage people to execute patient advocate designations in advance.
