Massachusetts End-Of-Life Planning

Copyright 2012 by Ronald B. Standler

Table of Contents
Introduction Massachusetts Law Links to Massachusetts Health-Care Proxy Resources Links to Nationwide Resources in the USA

Introduction

Every adult — including mentally incompetent people or unconscious people — has the right to refuse medical treatment, as explained in my technical legal essays:

Right to Refuse Medical Treatment, history and summary of law, with citation to many cases.
Right-To-Die, annotated judicial opinions that describe the legal right to discontinue a feeding tube or artificial ventilation.

The problem is that unconscious or mentally incompetent people can not express their right to refuse medical treatment. The law solves this problem in two ways. A mentally competent adult can (1) appoint an agent to make health-care decisions, and/or (2) write a "living will" to specifically reject some types of medical treatment.

This webpage tersely summarizes Massachusetts law on this subject, and gives links to Massachusetts resources on a health-care proxy (i.e., designation of an agent to make health-care decisions). I also include some links to nationwide resources in the USA on advance directives.

By way of introduction, I am licensed to practice law in Massachusetts since 1998. Annotated list of all of my essays on health law.

Disclaimer
This webpage is intended only to present general information about an interesting topic in law and is not legal advice for your specific problem. See my disclaimer. The following links are provided only as a convenience to readers of these pages. I receive neither income nor other consideration as a result of referrals or providing links to any entity. I make neither representations nor warranties about the contents of the websites at the following links.

Massachusetts Law

Massachusetts law does recognize the legal right-to-die (i.e., withholding food or water). Guardianship of Doe, 583 N.E.2d 1263 (Mass. 1992) (patient in persistent vegetative state).

Massachusetts law recognizes the right of a mentally competent adult to refuse medical treatment, even if that treatment would prolong life. See, e.g., Shine v. Vega, 709 N.E.2d 58, 65 (Mass. 1999); Norwood Hosp. v. Munoz, 564 N.E.2d 1017, 1021-1023 (Mass. 1991); Brophy v. New England Sinai Hosp., Inc., 497 N.E.2d 626, 633-634 (Mass. 1986) (dicta).

Massachusetts law does not recognize physician-assisted suicide.: Nothing in this chapter shall be construed to constitute, condone, authorize, or approve suicide or mercy killing, or to permit any affirmative or deliberate act to end one's own life other than to permit the natural process of dying.
Massachusetts General Laws, Chapter 201D § 12 (enacted 1990).
Moreover, the state has a common-law interest in preventing suicide. See, e.g., Brophy v. New England Sinai Hosp., Inc., 497 N.E.2d 626, 634 (Mass. 1986); Superintendent of Belchertown State School v. Saikewicz, 370 N.E.2d 417, 425 (Mass. 1977) (dicta).
As of 4 June 2012, no court opinion and no statute authorizes physician-assisted suicide in Massachusetts.

Health-Care Proxy & "Living Will"
in Massachusetts

A person who wishes to refuse some forms of life-sustaining medical treatment should consider signing two legal documents:

Health Care Proxy appoints an agent to make health-care decisions for a patient who "lacks capacity to make health care decisions". Recognized and enforceable under Massachusetts General Laws, Chapter 201D (enacted 1990).
A Living Will, also called an Advance Directive, specifies in detail the patient's desires for life-sustaining treatment, if the patient is in a long-term coma, persistent vegetative state, or other condition where the patient is unconscious and has no reasonable hope of recovery. A Living Will is not recognized in Massachusetts. Cohen v. Bolduc, 760 N.E.2d 714, 718, n.12 (Mass. 2002) ("Unlike some States, the Massachusetts statute does not provide for instructional, as opposed to agent-delegated, advance directives, and has no 'living will' provision."). However, a Living Will is still worth having because one could be hospitalized outside of Massachusetts, and the Living Will could be evidence in litigation in Massachusetts on the right-to-die.

There is no requirement to have a health-care proxy in Massachusetts. Signing a health-care proxy form is not a condition for receiving care from a physician or hospital in Massachusetts. If you sign a proxy form, you can change or revoke the proxy form at any time.

If you need legal advice, consult a licensed attorney who specializes in either Elder Law or Estate Planning.

Links to Massachusetts Resources
Health-Care Proxy

Massachusetts Trial Court Law Libraries Massachusetts Law About Health Care Proxies and Living Wills.
Massachusetts General Laws Chapt. 201D on Health Care Proxy.
Massachusetts Bar Association Living Wills and Health Care Proxies.
Massachusetts Medical Society End of Life Care,
Health Care Proxy Information and Forms.
Hospitals in Massachusetts:
- Beth Israel Deaconess Medical Center Massachusetts Health Care Proxy Information, excellent information.
- Dana-Farber Cancer Institute Health Care Proxy.
- Massachusetts General Hospital Planning Health Care, ALS Clinic. Forms not available online.
- MIT Medical Health Care Proxy
- Newton-Wellesley Hospital Proxy.
- Tufts Medical Center Health Care Proxy, excellent information, including detailed instructions and sample form.
Massachusetts Commission on End of Life Care homepage, group of state legislators, lawyers, and state government officials.

Links to Nationwide Resources in USA

U.S. Government, National Cancer Institute, Advance Directives.
American Bar Association, Commission on Law and Aging, Health Decisions,
Consumer's Toolkit for Health Care Advance Planning.
American Medical Association, Council on Ethical and Judicial Affairs (CEJA) Reports, End of Life Care.
National Hospice and Palliative Care Organization Caring Connections,
download advance directive forms for each state in the USA.
New York Online Access to Health Advance Directives nationwide. Private website by librarians.
Registry of Living Wills in the USA
Brown University webpage to teach Advance Directives to medical students.

this document is at http://www.rbs2.com/maplan.htm
created 4 June 2012, revised 18 Aug 2012

Annotated list of all of my essays on health law.