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Michigan House approves next-of-kin health care decision bills unanimously
Summary
The Michigan House passed legislation to establish a statutory next-of-kin/surrogate decision-making framework in the Estates and Protected Individuals Code, advancing protections for families and health‑care providers and ordering immediate effect.
The Michigan House of Representatives on Sept. 18 advanced and passed a package of bills to amend the Estates and Protected Individuals Code and create a statutory framework for surrogate or next-of-kin health-care decision making.
Representatives debated the package on the House floor before voting unanimously. Representative Breen, who spoke in support, said, “Together, these bills establish a clear, humane, and legally sound framework for surrogate or next of kin health care decision making in Michigan.” The clerk later announced the final recorded vote on House Bill 4418 as 98 ayes and 0 nays; House Bill 4418 was ordered to immediate effect. House Bill 4419 was recorded as 98 ayes and 0 nays and was also given immediate effect.
Why it matters: sponsors and supporters said the bills are intended to prevent unnecessary guardianship proceedings when an adult patient lacks an appointed decisionmaker and to give clinicians and families a clear legal standard in crisis situations. Representative Thompson described the bills as “pro family” and recounted a personal case in which she said her family’s out‑of‑state DNR and family‑decision ability were not honored after a patient was moved into Michigan; she told colleagues, “When he arrived in Michigan, everything changed. I was told they could not honor his DNR because it came from out of state.”
What the bills do: on second reading the House adopted a committee substitute for the package and accepted Representative Thompson’s amendment 1a. Supporters described the package as both establishing who may act as a surrogate when no durable power of attorney exists and shielding health‑care providers who act in good faith from liability while preserving penalties for bad‑faith actors. Representative Breen said the bills do not override an existing durable power of attorney: “When someone has already made those arrangements, their wishes will always come first.”
Process and votes: the clerk reported adoption of the substitute at second reading, adoption of amendment 1a, advancement to third reading, and then the recorded roll‑call votes on final passage. For House Bill 4418 the clerk announced “98 aye votes and 0 nay votes” and for House Bill 4419 the clerk announced “98 aye votes and 0 nay votes.” The majority floor leader moved for immediate effect on both bills; the House ordered immediate effect for both measures by voice vote.
What supporters said: proponents — including hospital, elder‑justice and disability advocates cited on the floor — said the change will align Michigan with other states that allow a next‑of‑kin surrogate to act when no appointed agent exists. Representative Breen said the bills have “broad support across Michigan from elder justice advocates, hospitals, disability rights organizations, and guardianship associations.”
Implementation notes: sponsors said the bills will clarify the order of decisionmakers when a durable power of attorney does not exist and create procedural protections for clinicians relying on surrogate decisions. The legislation’s advocates emphasized it is not intended to displace an existing power of attorney or advance guardianship in place of patient preference.
Next steps: because the House ordered immediate effect on both bills, the measures will take effect without the standard delay if they complete any remaining legislative steps required under state law.
