SB853, An Act Improving Medical Decision Making

Joint Committee on the Judiciary

The Massachusetts Hospital Association (MHA), on behalf of its member hospitals and health systems, appreciate this opportunity to offer its strong support for SB853. This bill would improve medical decision-making processes by establishing guidelines for healthcare providers to discuss medical treatment with an appropriate and legally valid surrogate when a patient is incapacitated and lacks a health care proxy.

Currently, hospitals and other healthcare providers work with patients to secure a legally valid health care proxy or the appointment of a legal guardian, as appropriate, to assist with full medical decision-making when a patient is incapacitated. However, in situations when a valid health care proxy has not been executed for an incapacitated patient, the court process to identify and appoint a valid legal guardian is lengthy, cumbersome, and expensive and may result in care being delayed for weeks before a court affirms the guardian.

44 other states in the country have successfully addressed this troubling bureaucratic delay by establishing a priority list of surrogates for incapacitated patients without health care proxies. SB853 would add Massachusetts to that list by creating a legally valid standard under which a treating health care provider could appoint a surrogate decision-maker – following the family hierarchy set forth - for non-extraordinary medical decisions for a patient who lacks a health care proxy. It is important to note that this hierarchy is the same list that the legislature has already approved for use in other legal and clinical settings, including obtaining consent for autopsies and laboratory testing. By appropriately accelerating the medical decision-making process under this model, this important bill will enhance safe and timely care for these patients.

MHA also supports the additional clarifications and safeguards to this legislation as proposed by the Massachusetts Medical Society to ensure the utmost patient protections.

MHA respectfully requests that the committee issue SB853, including the further MMS amendments, an expedited favorable report.

Thank you for your time and your consideration of this matter. If you have any questions or need further information, please do not hesitate to contact Michael Sroczynski, MHA’s Vice President of Government Advocacy at (781) 262-6055 or msroczynski@mhalink.org.