AB 653

This bill allows for next of kin to be a surrogate decision maker for a patient in

a hospital who is incapacitated in certain circumstances. Under the bill, when a

hospital patient is incapacitated, the attending physician for the patient must make

a reasonable inquiry as to whether the patient has a guardian of the person or an

advanced planning instrument that applies to the patient's condition. For purposes

of the bill, either two physicians, a physician and an individual who possesses a

resident education license, or a physician and a licensed advanced practice clinician,

who have personally examined the patient, must make the determination and sign

a statement specifying that the patient is incapacitated.

Under the bill, if there is no guardian or applicable advanced planning

instrument, the attending physician must make a reasonable inquiry as to the

availability of a surrogate decision maker by contacting any family member

identified in the patient's health care records or other personal effects. The bill

requires the attending physician to attempt to contact that person by telephone

within 24 hours after a determination is made that the patient is incapacitated.

Under the bill, the following individuals, in the following order of priority, may act

as a surrogate decision maker: 1) the patient's spouse or domestic partner; 2) an adult

child of the patient or, if there is more than one adult child, a majority of the adult

children who are available for consultation within a reasonable period of time; 3) a

parent of the patient; 4) an adult sibling of the patient or, if there is more than one

adult sibling, a majority of the patient's adult siblings who are available for

consultation within a reasonable period of time; 5) a grandparent of the patient; 6)

an adult grandchild of the patient or, if there is more than one adult grandchild, a

majority of the patient's adult grandchildren who are available for consultation

within a reasonable period of time; or 7) a close friend or relative of the patient if the

person is at least 18 years of age, has maintained sufficient regular contact with the

patient to be familiar with the patient's activities, health, and beliefs, and has

exhibited special care and concern for the patient. The bill provides that if a willing

surrogate decision maker is identified, the attending physician must record the

surrogate decision maker's information in the patient health records. The bill

includes provisions for recording a replacement surrogate decision maker if the

initial person identified becomes unavailable.

The bill provides that a surrogate decision maker may, if made in accordance

with certain requirements, make decisions for the patient concerning the patient's

care, treatment, or therapies without involving the courts or legal process, but a

surrogate decision maker may not make a decision to continue or to forego

life-sustaining treatment.

Under the bill, any decision made by a surrogate decision

maker must be recorded in consultation with the attending physician and must

conform as closely as possible to what the patient would have decided under the