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Bill

HD 2666

An Act relative to determining capacity and invoking the health care proxy

194th Legislature (2025-2026) Introduced by Danielle Gregoire

Massachusetts bill clarifies legal standards for assessing patient decision-making capacity and establishing when health care proxies assume medical decision-making authority.

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Bill Summary · HD 2666

Legislative bill overview

HD 2666 modifies Massachusetts law regarding how medical professionals determine a patient's decision-making capacity and establish when a health care proxy should take effect. The bill refines the legal standards and procedures for assessing whether patients can make their own medical decisions and clarifies the conditions under which designated proxies assume decision-making authority.

Why is this important

Capacity determinations directly affect patient autonomy and medical decision-making, particularly for elderly, seriously ill, or cognitively impaired individuals. Clear, consistent standards protect vulnerable patients from both premature removal of decision-making rights and delayed proxy activation when genuinely needed. These procedures impact end-of-life care, mental health treatment, and emergency medical situations across Massachusetts hospitals and care facilities.

Potential points of contention

  • Capacity assessment standards: Disagreement over how stringent capacity tests should be—stricter standards protect autonomy but may delay necessary proxy involvement; looser standards enable faster decisions but risk overriding capable patients' wishes
  • Provider discretion vs. standardization: Tension between allowing clinical judgment in capacity determinations versus establishing uniform criteria that prevent inconsistent application across different hospitals and providers
  • Timing of proxy activation: Balancing the need for rapid decision-making in medical emergencies against ensuring adequate time to attempt restoring or confirming patient capacity before proxy authority begins

Compiled from official sources — confirm details with the bill’s official record.

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