You explain that where no Power of Attorney has been assigned by the patient or a court, then decision-making authority falls to the next-of-kin. This would be a spouse, if there is one, then an adult child, then a parent.
“He’s not actually married, so I guess it’s his mom then.”
You remind Mr. Garcia that if Mr. Black regains his ability to communicate or otherwise has an improvement in his cognitive state, the care team should consider assessing his Capacity. If it is at all possible, Mr. Black should be included in discussions about his care.
After recording the details of the consultation, you return to your other duties.
A couple of weeks later you are lunching with a social worker friend in the hospital cafeteria. She mentions that morale in the ICU is very poor. “A lot of the nurses feel that the ICU docs don’t listen to them,” she tells you. “We had a patient die last week who really should have been moved to hospice. But his mom was really religious and the doc just kept pushing new treatments and saying they might work. You know how it is—the family hears about an experimental treatment and they think cure! The poor guy really suffered unnecessarily.”
She shrugs and looks at you. “We really should get you involved more when there are disagreements. They really need an outsider who can mediate.” You make a mental note to ask more questions next time and try to get to the bottom of the ethical issues that concern the people who call you.