What Happens If You Become Incapacitated in a Hospital? Who Makes the Decisions?

No one ever wants to think about the possibility of becoming incapacitated, especially when it comes to making crucial medical decisions. But life is unpredictable—accidents, unexpected surgeries, or sudden health issues can leave us unable to make decisions for ourselves. When that happens, it’s essential to understand who will make those decisions and how your healthcare choices will be honored.

Unfortunately, there are common misconceptions about who gets to make these decisions. Many people believe that their children will automatically step in to make medical decisions on their behalf, but that’s not always true. In fact, the lack of clarity and proper planning can cause unnecessary confusion and even disputes among family members during an already emotional time.

In this article, we’ll explore the ins and outs of medical decision-making when you become incapacitated. We’ll break down who can make decisions for you, the role your children might play, and, most importantly, how you can plan aheadto ensure that your wishes are respected.

The Default Medical Decision-Makers in California

California law has a specific order of priority for making medical decisions when someone is unable to do so themselves. The law isn’t as simple as just letting your children take charge. In fact, many individuals are shocked to learn that it’s not always their children who will have the final say. Here’s how the process works if you are incapacitated and unable to communicate your medical preferences:

1. Spouse or Domestic Partner
   If you’re married or in a domestic partnership, your spouse or partner is typically the first person authorized to make medical decisions on your behalf. This is because they are considered your closest family member under the law. If you're not married, your domestic partner may have the same rights.

2. Adult Children
   If you don’t have a spouse or domestic partner, your adult children may be next in line. However, there’s a critical detail to understand: if you have more than one child, they must all agree on your treatment decisions. While this sounds straightforward, it can quickly become complicated. Imagine a situation where your children don’t agree on a specific course of action. One child might want to pursue aggressive treatment, while another may think it’s time to let go. In cases of disagreement, your family might have to go to court to resolve the issue.

3. Parents or Siblings
   If you don’t have a spouse, domestic partner, or children, your parents or siblings may be the next in line to make decisions on your behalf. However, as with your children, disagreements can arise, and your family might find themselves in the difficult position of having to make life-altering decisions without clear guidance from you.

The Role of Your Children in Medical Decisions

There’s often confusion about the role children play in medical decision-making, especially if they’re adults. People frequently assume that if they have children, those children will automatically be able to make healthcare decisions for them if they become incapacitated. But that’s not necessarily the case.

If you are married or have a domestic partner, your spouse or partner has priority over your children. Furthermore, if your children are minors, they won’t have any legal say in your medical care. Even if your children are adults, they must come to a unanimous decision regarding your care. If the family can’t agree, the matter may need to be settled by the court.

This is why planning ahead is crucial. The last thing you want is for your children to be stuck in a situation where they are unable to make decisions because they don’t have legal authority to do so, or worse, forced into conflict over what’s best for you.

How to Ensure Your Wishes Are Respected: Advance Directives and Powers of Attorney

To avoid family disputes and ensure that your healthcare decisions align with your values, it’s vital to have the proper legal documents in place. Two primary tools can help you plan ahead: a Healthcare Power of Attorney and an Advance Healthcare Directive.

1. Healthcare Power of Attorney (Durable Power of Attorney for Health Care)

A Healthcare Power of Attorney (also known as a Durable Power of Attorney for Health Care) allows you to designate someone you trust to make healthcare decisions on your behalf if you are unable to do so. This document gives your agent—the person you appoint—legal authority to make decisions about medical treatments, surgeries, end-of-life care, and more.

It’s important to note that you can designate anyone you trust, not just your spouse or children. Many people choose a close friend, relative, or even a trusted attorney to serve as their agent. Additionally, you can name a successor agent in case your first choice is unavailable or unwilling to act.

Having this document in place ensures that the person you trust the most will be in charge of making critical healthcare decisions for you, and they’ll be able to do so according to your preferences.

2. Advance Healthcare Directive (Living Will)

An Advance Healthcare Directive (also known as a living will) outlines your specific wishes regarding medical care. This document is a detailed guide that can clarify what kind of treatment you want if you’re incapacitated. For example, you can specify whether you want life support, artificial nutrition, organ donation, or palliative care.

It’s important to remember that your Healthcare Power of Attorney and Advance Healthcare Directive work together. The directive provides your agent with specific instructions on how you would like to be treated, ensuring that your preferences are carried out if the situation arises.

Why You Should Plan Now, Not Later

Many people avoid thinking about healthcare planning because it feels morbid or unnecessary. However, not planning ahead can create more problems for your loved ones than you can imagine. If you’re incapacitated without the proper legal documentation, your family may be forced to make difficult decisions without guidance, potentially leading to confusion, conflict, or even legal battles.

Moreover, without clear instructions, your family may be left to interpret what you would have wanted—leading to the very disagreements you hoped to avoid. It’s a situation no one wants to face, but the consequences of not having a plancould be far more painful for your loved ones than the discomfort of taking a few steps to ensure your wishes are respected.

What Happens If There's a Disagreement?

In the event of a family disagreement, the situation can get complicated. Imagine this scenario: your family is already in a crisis, trying to figure out what to do, and your children are in conflict over the best course of action for your health. If they can’t agree, your case may end up in court, where a judge will decide who gets to make the final call on your care. This is an emotionally exhausting and expensive process, and it can severely strain relationships between family members.

Having an advance directive and healthcare power of attorney in place prevents this. It removes uncertainty and empowers the person you trust to act on your behalf without delay or legal interference.

What You Should Do Next

If you haven’t already set up a healthcare power of attorney or an advance healthcare directive, it’s time to make that a priority. At Brentwood Law, we specialize in estate planning and can help you create these critical documents to ensure your healthcare wishes are respected.