Next-of-kin laws appear outdated.

• Position: Medical Decisionmaking - Brief article

Laws governing medical decisionmaking for patients who lose capacity vary from state to state. If a spouse, sibling, parent, or child is not available, critical medical decisions may be delayed because "default consent" statutes in many states do not recognize non-nuclear family relationships. To determine how many patients might be affected by this issue, postdoctoral fellow Andrew B. Cohen of Yale University, New Haven, and colleagues examined data collected by Connecticut's Veterans Health Administration over a 10-year period.

The researchers found that six percent of patients who received care at VHA facilities named non-nuclear family contacts as next of kin. Often, those patients listed an intimate contact outside of marriage, such as "same-sex partner," "common law spouse," and "live-in soul mate."

For those under age 65, the percentage of non-nuclear next of kin was even higher. 'The finding is significant because it may be a reflection of how family structures are changing," says Cohen. "We may see the percentage grow further as people experience more diverse kinds of close relationships."

If confirmed...