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

 

Organ donation can save lives, but a recent investigation revealed how a lack of planning can lead to devastating mistakes. Read more…

2025.07.11

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

When you think about estate planning, you probably picture wills, trusts, and who gets what. But what happens when decisions are made about your body, without your full consent or when you're not really gone?

A recent federal investigation uncovered a chilling truth: in dozens of cases, patients showed signs of life even as hospital staff prepared to remove their organs. If your loved ones were in that position, would they know what to do? More importantly, would they know what you would want?

In this article, I’ll explain how a comprehensive Life & Legacy Plan protects not just your loved ones, but you. We’ll explore the risks of poor planning, how to make your medical wishes known, and how to ensure no one makes life-or-death decisions for you without your voice.

Organ Donation Without Clarity Can Go Horribly Wrong

According to a June 2025 New York Times report, in 2021, Anthony Thomas Hoover II's family faced their worst nightmare when he overdosed and was near death. They gathered and made the excruciating decision to end life support and donate his organs. As the hospital prepared for the removal procedure, something surprising happened. 

He woke up.

Hoover cried, pulled his knees to his chest, and shook his head “no” as doctors moved forward. It took a hospital physician to step in and halt the process. Hoover survived, though he sustained neurological damage.

Astonishingly, this happens more often than most people may think. The federal investigation reviewed over 350 cases and flagged 73 where patients had shown signs of consciousness during the donation process. Some survived long enough to recover. Others died days later, without ever having their wishes clarified.

Unfortunately, in the absence of clear instructions, loved ones, hospitals, and donation agencies must make fast decisions—sometimes under pressure, and sometimes without the information they need from you. This puts them in a very tough and emotionally challenging situation. 

One way to prevent this nightmare scenario from happening to you or someone you love is through clear communication, legal authority, and comprehensive planning. But first, let’s take a deeper dive into what happens when you haven’t prepared for this nightmare scenario.

How Hospitals Make Decisions When You Don’t

When you haven't created a plan that legally appoints a healthcare agent or outlines your care preferences, hospitals rely on state laws and default policies to make decisions on your behalf. This process can be chaotic, impersonal, and completely disconnected from what you would actually want.

Here's what typically happens when you don't have your own plan in place. First, medical staff will review any existing documentation, including your driver's license for organ donor status, search for advance directives in your medical records, and consult hospital databases. If they find nothing, they turn to state law to determine who has the legal authority to make decisions for you.

The state's default hierarchy usually prioritizes spouses first, then adult children, then parents, then siblings. But what if you're estranged from your spouse? What if your adult children disagree with each other? What if the person the state chooses doesn't actually know your values or wishes?

In emergency situations, time pressure makes everything worse. Hospital staff need quick decisions about life support, treatment options, and potential organ donation. Without clear guidance from you, your loved ones may feel forced to make impossible choices based on incomplete information, their own emotions, or pressure from medical staff.

Knowing all this, what can you do to keep your loved ones from having to make these emotionally painful decisions? You can create a plan that works when you and your loved ones need it to. 

Key Documents That Protect Your Medical Wishes

One part of planning that works is creating specific legal documents that give your loved ones the authority and guidance they need. Each document serves a different purpose, but they work together to ensure your wishes are followed. Here are the typical documents - tools, really - that you’ll create when you work with me as your Personal Family Lawyer:

A Living Will outlines your preferences for life-sustaining treatments, such as ventilation, resuscitation, and artificial nutrition. This document tells medical professionals and your loved ones exactly what you want if you're unable to communicate. Do you want to be kept alive at all costs? Are there circumstances where you'd want treatment stopped? Your directive provides these answers in writing.

A Durable Power of Attorney for Healthcare names the specific person you want to speak on your behalf if you can't. This person becomes your healthcare proxy, with legal authority to make medical decisions according to your wishes. Without this document, hospitals must follow state law to determine who can make decisions for you, and that person might not be who you would choose.

For the sake of clarity, know that some states combine the Living Will and the Durable Power of Attorney for Health Care into one document called the Advance Directive for Healthcare. 

HIPAA Authorization forms ensure your chosen decision-makers can access your medical information. Even close family members can be blocked from receiving medical updates unless you've given them written permission. This document removes barriers that could prevent your healthcare proxy from getting the information they need to advocate for you.

A document that isn’t usually part of traditional estate plans but that I can help you create as part of my Life & Legacy Planning^Ⓡ model is an Organ Donation Instructions document, which goes beyond simply checking a box on your driver's license. Your preferences around donation should be clearly documented and aligned with the rest of your plan, including specific instructions about when organs can be removed and under what circumstances. This prevents situations like Anthony Hoover's, where families must guess what you would have wanted. 

Having these documents in place is an integral part of your plan, but not the entire plan. You need more than just the documents or you risk failing your loved ones - and yourself.

Why Documents Alone Aren't Enough

While these documents are essential, they're just pieces of paper unless they're part of a comprehensive plan that actually works when you need it. Too many people think that signing a few forms means they're protected, but documents sitting in a drawer can't speak for you in a crisis.

In addition, documents can become outdated as your health, family situation, or values change over time. The healthcare directive you signed ten years ago might not reflect how you feel today about end-of-life care. Your chosen healthcare proxy might have moved away, become ill themselves, or simply be unavailable when needed.

Even current, properly executed documents can fail if your loved ones don't know where to find them or how to use them effectively. In the chaos of a medical emergency, family members might not know these documents exist, or hospital staff might not have immediate access to them. They need to be able to access the documents at the moment they need them.

But perhaps most importantly, documents can't replace the conversations you need to have with your loved ones about your end-of-life wishes. If you haven't talked openly about what you want—and why you want it—you're leaving your family to make excruciating decisions on their own, wondering if they're doing the right thing or whether their decisions will be the catalyst for long-term conflict.

When you take the time to have these difficult conversations—explaining not just what you want, but why you want it—you lift an enormous burden from their shoulders. Instead of agonizing over an impossible choice, they can act with confidence, knowing they're honoring your wishes. You’re also potentially preventing disputes among family members who may disagree about your care. 

Ultimately, your loved ones need someone they can turn to for guidance when faced with impossible choices. They may need support in understanding your intent and advocating for your wishes when medical staff might pressure them to make different decisions. 

All of this, and more, is just one reason why when I work with you, I’ll be your Personal Family Lawyer and trusted advisor for life - and your family’s advisor if you’re incapacitated or when you die. They’ll have a heart-centered human who knows you, your values, your wishes, and your intentions, and can see them through a difficult time with not only the legal support they need, but also the emotional support they want. 

Book a 15-Minute Discovery Call to Start Your Plan

If the idea of being treated like an organ donor before you're actually gone makes your stomach turn, you’re not alone. What happened to Anthony Hoover and others like him is tragic—but preventable.

With a comprehensive Life & Legacy Plan in place, you can make sure your medical choices are respected, your family is protected, and no one ever has to question whether they did the right thing for you. 

When you work with me, I’ll be there not just to help you plan, but to guide your loved ones in an emergency and after you die. During those first frantic hours or days in a hospital, when emotions run high and decisions must be made quickly, your family won’t be left to figure it out alone. They’ll have me to turn to—someone who knows you, understands your values, and can help them navigate what comes next with clarity, compassion, and confidence. Your loved ones won’t be dealing with an overwhelmed hospital system or a stack of confusing paperwork—they’ll have a real human being to lean on.

To learn more about how I support you and your loved ones for life, book your 15-minute discovery call with me today.

https://calendly.com/myachorlaw/15min

This article is a service of Attorney John F. Koenig, Anchor Law, Life and Legacy Planning, LLC, a Personal Family Lawyer® Firm. We don’t 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 comprehensive Life & 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 calling our office today to schedule a Life & Legacy Planning Session™.

The content is sourced from Personal Family Lawyer® for use by Personal Family Lawyer® Firms, a source believed to provide accurate information. This material was created for educational and informational purposes only and is not intended as ERISA, tax, legal, or investment advice. If you are seeking legal advice specific to your needs, such advice services must be obtained on your own separate from this educational material.