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March 2, 2011

Preserving Rights for Individuals Facing Guardianship

Author Affiliations

Author Affiliations: VA Boston Healthcare System and Harvard Medical School, Boston, Massachusetts (Dr Moye); and Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas (Dr Naik).

JAMA. 2011;305(9):936-937. doi:10.1001/jama.2011.247

The issue of adult guardianship poses increasing challenges in an aging society. Physicians play an essential role in ensuring its equitable and appropriate application. Yet physicians may be unaware of the evolution of guardianship law over the past 2 decades.

Physicians are knowledgeable about their older patients' functioning and such patients' experiences with elder abuse, neglect, or exploitation. As a result, physicians are identified to provide opinions regarding the capacity of their patients to live safely in the community or to manage health and financial affairs when a question of guardianship is raised. In most states, guardianship concerns the capacity to make personal decisions about health, home, and personal matters, and conservatorship concerns decisions about financial management. Guardianship and conservatorship are legal interventions by the state in which the rights to make decisions are removed from one person and assigned to another after a hearing. Reform of guardianship law throughout the United States places physician reports in a central evidentiary role for balancing individual rights with protections for older adults facing guardianship.

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