Hospice waits on a court order when no family can speak for you

A man is dying. He cannot speak, and no one in his life can say what he would have wanted. Kirsten Engel is a palliative medicine physician, and Medha Tripathi is a health writer and incoming Fulbright research scholar. This episode is based on their article "Guardianship and hospice care fail dying patients," published on KevinMD. They explain what happens when a patient has no family and no health care proxy, and a court appoints a guardian who has never met them. A move to comfort measures then needs a court date that can take weeks, while the hospital works in hours and days. Estimates range from 5 to 25 percent of intensive care patients with no family member or proxy. You will hear what helps now: your state's rules, hospital social workers and ethics committees trained for them, and a proxy named long before anyone needs one. If you have never named one, this conversation explains who decides in your place, and what has to change so the decision comes in time.

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