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us Death, bereavement & serious family crises hospital urgent call • end of life decisions • surrogate decision maker • health care proxy • advance directive question • living will discussion • dnr order discussion • polst form question • family meeting hospital • palliative care consult • ethics consult request • pressured to decide • relative in icu • comfort care decision • life support questions • what to ask the doctor • who can consent • hipaa personal representative • making decisions for parent

What to do if…
a hospital asks you to come in urgently to discuss end-of-life decisions for a relative

Short answer

Go in (or join by phone/video) and ask the team to state clearly what decision is needed today and who is legally allowed to make it. Before agreeing to anything, ask whether there’s an advance directive or named health care proxy and request a palliative care conversation if end-of-life choices are on the table.

Do not do these things

  • Do not consent to major treatment changes while you feel rushed—if it’s time-critical, ask for a brief, structured summary (options, likely outcomes, recommendation) and have your questions documented.
  • Do not assume the closest relative can automatically decide; authority depends on a health care proxy/guardian or your state’s surrogate rules.
  • Do not treat “DNR” as the whole conversation—ask what other treatments are (or aren’t) being recommended and why.
  • Do not sign paperwork you don’t understand; ask for the form name and a plain-language summary first.
  • Do not rely on memory alone—write down names, roles, and what was said.

What to do now

  1. Confirm the urgency and your options to join. Ask: “Is this decision needed today, and what happens if I can’t arrive for a few hours?” If you can’t be there, request a phone/video family meeting and the unit’s direct number.
  2. Ask the key legal-authority question immediately. Say: “Who is the legally recognized decision-maker for my relative right now?” Ask them to check for:
    • a health care proxy / durable power of attorney for health care
    • a living will / advance directive
    • a court-appointed guardian (if any)
    • POLST or a similar portable medical order (names vary by state) — ask what it’s called locally and whether one is on file
      If you have documents, bring them or send clear photos.
  3. Ask whether your relative can still make their own decisions. If your relative has decision-making capacity, ask how the team will include them (and how you can support them without speaking over them).
  4. Get clarity on what decision is actually being requested. Ask: “Is this about DNR, intubation/ventilator, ICU transfer, dialysis, feeding tubes, surgery, antibiotics, or switching to comfort-focused care?”
  5. Use a short, stabilizing question set. Ask:
    • “What are you most worried will happen in the next 24–72 hours?”
    • “What is the best-case and most likely outcome with this treatment? Without it?”
    • “What would this look like for them day-to-day if it ‘works’?”
    • “What are you recommending, and what is the reasoning for this patient?”
  6. Request the right teams for end-of-life decision support.
    • Ask for a palliative care consult (comfort, symptom control, goals-of-care conversations).
    • If there is conflict or uncertainty, request an ethics consult (many hospitals have an ethics service) to help structure the decision process.
  7. Protect against misunderstanding and later confusion.
    • Ask for a written summary in the chart (or a printed after-visit summary if available): “Can you document what we decided and why?”
    • Ask for the specific order name if discussed (e.g., “DNR order”) and what it does and does not mean at that hospital.
  8. If HIPAA is limiting what they’ll tell you, ask the right way. Say: “Am I recognized as the patient’s personal representative or authorized contact? If not, what do you need from me (documents) to speak with me?” If your relative can still consent, ask staff to have them give permission for you to receive updates.
  9. If family members disagree, slow it down and set a process.
    • Ask the team to identify the legally authorized decision-maker (one person).
    • Request a scheduled family meeting with the attending physician (or ICU team) plus palliative care to reduce mixed messages.

What can wait

  • You do not need to make decisions today about funeral arrangements, obituaries, estate matters, or long-term family logistics.
  • You do not need to “solve” family conflict right now—focus on clarifying who decides and what your relative would want.
  • You do not need to remember everything—your immediate goal is clarity, documentation, and support.

Important reassurance

This meeting is often about matching care to the person’s values when time is short—not about you “choosing” whether they live or die. Hospitals call families in urgently because medical changes can happen quickly and they need informed decisions and clear documentation. Feeling overwhelmed, guilty, frozen, or tearful is a common, normal response.

Scope note

This guide covers first steps for the urgent hospital meeting. The legal details of surrogate decision-making and specific forms (advance directives, POLST) vary by state and situation, so the hospital team may need to explain what applies in your case.

Important note

This is general information, not legal or medical advice. If you are unsure about authority to decide, ask the hospital to explain their policy and your state’s requirements, and consider requesting an ethics consult or the hospital’s patient relations/patient advocate support.

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