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Research Letter
April 7, 2015

Patients With Next-of-Kin Relationships Outside the Nuclear Family

Author Affiliations
  • 1Department of Medicine, Yale University School of Medicine, New Haven, Connecticut
  • 2VA Connecticut Health System, West Haven, Connecticut
JAMA. 2015;313(13):1369-1370. doi:10.1001/jama.2015.2409

For patients who lose capacity and have no legally appointed surrogate decision maker, most states have laws that specify a hierarchy of persons who may serve as surrogate decision makers by default.1 A patient’s spouse is usually given priority, followed by adult children, parents, and siblings.

Even though an increasing number of adults are unmarried and live alone,2 state default surrogate consent statutes vary in their recognition of important relationships beyond the nuclear family, such as friends, more distant relatives, and intimate relationships outside marriage.3 Little is known, however, about how often patients identify a person who is not a nuclear family member as their next of kin.