The Life-or-Death Decisions Your Family Shouldn't Have to Make Alone

Sabine Franco
Jul 22
3 min read

Why Medical Planning Is Just as Important as a Will

When you think about estate planning, you probably picture wills, trusts, and who gets what. But what about the decisions made when you're incapacitated—before you pass away? What happens if you're unable to speak, and your family is forced to make life-or-death decisions on your behalf without clarity?

A recent federal investigation revealed chilling cases where patients showed signs of life even as hospitals prepared to harvest their organs. These weren’t just paperwork errors, they were preventable tragedies.

In 2021, Anthony Thomas Hoover II was declared near death after an overdose. His family made the agonizing decision to donate his organs. As doctors prepared for removal, Hoover shocked everyone, he woke up. He cried, shook his head, and pulled his knees to his chest. A hospital physician stopped the procedure just in time. Though Hoover survived, he sustained serious neurological damage.

According to a June 2025 New York Times report, Hoover’s case isn’t isolated. A federal investigation into more than 350 cases flagged 73 where patients displayed signs of consciousness during organ procurement procedures.

Why is this happening? In the absence of clear legal documents and advance instructions, medical professionals are left to act under pressure. Families must make impossible decisions quickly, often without understanding your actual wishes.

How Hospitals Make Medical Decisions When You Don’t Have a Plan

When you haven’t completed legal planning that appoints a healthcare proxy or outlines your medical choices, hospitals follow a default chain of command:

They check for a living will, organ donor registration, or healthcare directive.
If nothing is found, they rely on state law to determine who can make decisions—often starting with a spouse, then adult children, then parents, then siblings.

This may sound logical, but reality is more complicated:

What if you’re estranged from your spouse?
What if your children disagree?
What if your next-of-kin doesn’t know your values?

In emergencies, every minute counts. Without a plan, your loved ones may be forced to make high-stakes decisions they’re emotionally unprepared for—with no idea if they're doing what you would have wanted.

Key Documents That Protect Your Medical Wishes

The good news? You can avoid this entirely by putting the right legal documents in place.

Living Will

This outlines your preferences for life-sustaining treatments such as ventilators, resuscitation, and artificial nutrition. It provides clarity for your loved ones and medical staff if you’re unable to communicate.

Durable Power of Attorney for Healthcare

This names the person you want to speak for you if you can’t. Also known as a healthcare proxy, this person is legally empowered to make medical decisions that align with your values—not just what a hospital or state law dictates.

Advance Healthcare Directive

Some states combine the Living Will and Healthcare Power of Attorney into a single document. Either way, the goal is to ensure your wishes are known and legally enforceable.

HIPAA Authorization

This document gives your chosen advocates access to your private medical information. Without it, even your spouse or parent might be denied updates in a crisis.

Organ Donation Instructions

Don’t leave organ donation up to chance, or a checkbox on your driver’s license. As part of your legacy plan, we’ll document your exact preferences and integrate them with your other medical instructions.

Why Legal Documents Alone Aren’t Enough

Here’s the uncomfortable truth: documents can fail.

They might be outdated.
Your proxy might be unreachable.
Your family might not know where the documents are—or how to use them.

Even the most well-written legal form is just paper without context. That’s why your plan needs more than documents. It needs conversation.

Have the difficult discussions with your loved ones now, about what you want, what you don’t, and why. This not only gives them confidence in moments of crisis but prevents conflict among family members who may disagree.

This article is a service of The Ambitious Legacy Firm. We do not just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Legacy Planning Session, during which you will get more financially organized than you’ve ever been before and make all the best choices for the people you love. You can begin by using the link below to schedule a call with our Client Services Director, who will be able to guide you on scheduling your Legacy Planning Session.

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