The civic record
Read. Follow. Verify.Missouri bill establishes a designated health care decision-maker priority list for incapacitated patients
Last action · May 15, 2026: Referred: Emerging Issues(H)Sponsors: Dean Van Schoiack and 1 other
Track this bill to get notified when it advances a stage. One tap to stop, anytime.
What This Bill Would Do
House Bill 1886 establishes the Designated Health Care Decision-Maker Act, creating a prioritized list of family members and associates who can make medical decisions for adult patients lacking a designated agent or guardian. The legislation sets strict rules for withdrawing life-sustaining treatment or artificial nutrition and hydration, provides liability protections for healthcare providers making reasonable contact efforts, and allows providers to decline care based on moral or religious objections while facilitating patient transfer.
The measure determines who legally holds medical proxy authority for individuals without existing durable powers of attorney, directly altering how hospitals and nursing homes handle consent, end-of-life care, and patient transfers.
- The General Assembly of Missouri considers legislation governing health care decision-making procedures and surrogate consent for incapacitated patients. context
Who It Would Affect
Groups the bill's text would affect if enacted, as described in the record. Being affected is not a position for or against it.
incapacitated persons
Their medical care, treatment options, and end-of-life decisions will be managed by a statutorily prioritized surrogate decision-maker when they lack capacity.
healthcare providers and facilities
They must follow contact procedures to identify decision-makers, rely on certified medical judgments, and are granted rights to transfer patients based on moral or religious objections.
patient family members
They receive a structured legal priority order to step in as surrogate decision-makers for incapacitated relatives.
Key Facts
- The measure establishes a specific priority order for designated health care decision-makers, starting with the spouse, followed by adult children, parents, siblings, grandparents or grandchildren, other relatives, religious community members, close friends, or unanimous designees.
- Two licensed physicians must determine after reasonable inquiry that a patient is incapacitated before a designated health care decision-maker may act.
- Physicians or designees must make reasonable efforts to contact potential decision-makers within twenty-four hours of an incapacity determination by examining personal effects and medical records.
- A designated health care decision-maker is deemed a personal representative for accessing private medical information under HIPAA regulations.
Show all 8 facts
- Withholding or withdrawing artificially supplied nutrition and hydration requires certification by two licensed physicians that it is not necessary for comfort or cannot be physiologically assimilated.
- Individuals with active, substantiated reports of abuse or neglect involving the patient are excluded from serving as decision-makers.
- Healthcare providers and facilities may decline to comply with decisions that violate their religious beliefs or sincerely held moral convictions, provided they do not impede patient transfer.
- Decision-makers are explicitly prohibited from withholding nutrition or hydration with the intent of hastening or causing the death of the patient.
Frequently Asked Questions
Who can make medical decisions if an incapacitated patient has no designated agent or guardian?
Can a healthcare provider refuse to follow a decision made by a designated decision-maker?
What requirements must be met before artificially supplied nutrition or hydration can be withdrawn?
What else do you want to know?
News Coverage
Follow the record
Votes, people, money & the original sourceWhere This Stands
Currently in committee. The next step in the legislative lifecycle is Floor Vote.
Procedural history
4 actions- May 15, 2026HouseCommitteeReferred: Emerging Issues(H)
- Jan 8, 2026HouseFloorRead Second Time (H)
- Jan 7, 2026HouseIntroducedRead First Time (H)
- Dec 1, 2025HouseIntroducedPrefiled (H)
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →Lobbying Activity
No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.
Full breakdown
Who this bill affects and the strongest case for and against it, written only from the bill’s own text.
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Creation of Statutory Surrogate Hierarchy
The bill creates a formalized statutory hierarchy for medical decision-making in the absence of pre-existing legal instruments like durable powers of attorney.
Connected Entities
Sources
house.mo.gov
Analysis Score
0–100- Significance75How much this matters to a regular citizen
- Controversy45Intensity of disagreement among stakeholders
- Entertainment5Compellingness for a non-policy-wonk reader
- Buzz20Current news / social attention level
Publisher tools