The Life-or-Death Decisions Your Family Shouldn’t Have to Make Alone
August 20, 2026
Organ donation can save lives, but a recent investigation showed how unclear planning and rushed decisions can lead to devastating mistakes.
When you think about estate planning, you may picture wills, trusts, and decisions about who receives your property. But what happens when decisions are made about your body without your full consent, or before it is completely clear that you are truly gone?
A recent federal investigation uncovered a disturbing reality. In dozens of cases, patients reportedly showed signs of life while hospital staff were preparing to remove their organs. If someone you love were placed in that situation, would your family know what to do? More importantly, would they understand what you would want?
In this article, I will explain how a comprehensive Life & Legacy Plan can protect not only your loved ones, but you as well. We will look at the dangers of unclear planning, how to document your medical wishes, and how to help ensure that no one makes life-or-death decisions on your behalf without your voice being heard.
Organ Donation Without Clear Instructions Can Go Terribly Wrong
According to a June 2025 New York Times report, Anthony Thomas Hoover II’s family faced a nightmare in 2021 after he overdosed and was believed to be near death. His loved ones gathered and made the painful decision to end life support and donate his organs.
As the hospital prepared for the organ removal procedure, something unexpected happened.
He woke up.
Hoover cried, pulled his knees toward his chest, and shook his head “no” while the procedure was being prepared. A hospital physician eventually intervened and stopped the process. Hoover survived, although he experienced neurological damage.
What is especially alarming is that this may not have been an isolated incident. A federal investigation reviewed more than 350 cases and identified 73 in which patients reportedly showed signs of consciousness during the organ donation process. Some lived long enough to recover. Others died days later without ever having their wishes clearly understood.
When there are no clear instructions, family members, hospitals, and organ donation organizations may have to make urgent decisions under intense pressure. They may also be forced to act without knowing what the patient truly wanted.
This places loved ones in an extremely difficult and emotionally overwhelming position.
Clear communication, legal authority, and comprehensive planning can help reduce the risk of this kind of nightmare. But first, it is important to understand what can happen when no plan exists.
How Hospitals Make Decisions When You Don’t
If you have not created a plan that legally appoints a healthcare decision-maker or explains your care preferences, hospitals must rely on state law and internal policies to make decisions for you. That process can be stressful, impersonal, and completely disconnected from your actual values.
Here is what often happens when no plan is available.
Medical staff may first review existing records, check your driver’s license for organ donor status, look for advance directives in your medical file, and search available hospital databases. If they find no clear instructions, they generally turn to state law to determine who has authority to make decisions on your behalf.
The default order usually begins with a spouse, followed by adult children, parents, and then siblings.
But what if you are separated or estranged from your spouse? What if your adult children disagree? What if the person given authority under state law does not understand your beliefs or wishes?
In a medical emergency, time pressure makes these problems even harder. Hospital staff may need immediate decisions about life support, treatment options, resuscitation, or possible organ donation. Without clear instructions from you, your loved ones may feel forced to make impossible choices based on incomplete information, personal emotion, or pressure from medical professionals.
So what can you do to prevent your family from facing those decisions alone?
You can create a plan that works when you and the people you love need it most.
Key Documents That Protect Your Medical Wishes
An effective plan includes specific legal documents that give your loved ones both the authority and guidance they need. Each document serves a different purpose, but together they help ensure that your wishes are understood and followed.
Here are some of the tools we typically create when you work with me as your Personal Family Lawyer®.
A Living Will
A Living Will explains your preferences regarding life-sustaining treatment, including ventilation, resuscitation, and artificial nutrition.
This document tells your loved ones and medical professionals what you want if you can no longer communicate. Do you want every possible treatment used to keep you alive? Are there circumstances under which you would want treatment stopped? Your Living Will places those decisions in writing.
A Durable Power of Attorney for Healthcare
A Durable Power of Attorney for Healthcare names the person you trust to speak for you if you cannot speak for yourself.
That person becomes your healthcare proxy and receives legal authority to make medical decisions based on your instructions and values. Without this document, the hospital may have to follow state law to determine who is allowed to decide, and that may not be the person you would have selected.
In some states, the Living Will and Durable Power of Attorney for Healthcare are combined into one document called an Advance Directive for Healthcare.
HIPAA Authorization Forms
HIPAA Authorization forms allow the people you have chosen to receive your medical information.
Even close family members may be denied access to updates about your condition unless you have given written permission. This document helps remove barriers that could prevent your healthcare proxy from receiving the information needed to advocate for you effectively.
Clear Organ Donation Instructions
Traditional estate plans do not always include detailed organ donation instructions, but this is something I can help you address as part of the Life & Legacy Planning® process.
Your preferences can be included in your Power of Attorney for Healthcare or documented on a separate page kept with your estate plan. This provides more clarity than simply checking an organ donor box on your driver’s license. Your wishes regarding donation can be clearly recorded and coordinated with the rest of your medical planning.
These documents are essential, but they are not the entire plan. Documents alone may still fail you and the people you love.
Why Documents Alone Are Not Enough
These legal documents are important, but they are only pieces of paper unless they are part of a complete plan that can be found and followed during an emergency.
Too many people believe that signing a few forms means they are fully protected. But documents stored in a drawer cannot speak for you during a crisis.
Documents can also become outdated as your health, relationships, and personal values change. A healthcare directive you signed ten years ago may no longer reflect how you feel about life support or end-of-life treatment. The person you selected as your healthcare proxy may have moved away, become ill, or become unavailable.
Even current and properly signed documents can fail if your loved ones do not know they exist or cannot access them quickly. During the confusion of a medical emergency, family members may not know where the documents are stored, and hospital staff may not be able to obtain them when decisions must be made.
Your family needs access to those instructions at the exact moment they are needed.
Most importantly, legal documents cannot replace the conversations you should have with the people you love. If you have never explained what you want and why you want it, your family may still be left making painful decisions alone. They may spend years wondering whether they made the correct choice or blaming one another for the outcome.
When you take the time to discuss your wishes openly, including the reasons behind them, you lift a tremendous burden from your family.
Instead of struggling with uncertainty, they can act with confidence because they know they are honoring your wishes. These conversations can also reduce the risk of disputes among relatives who may have different opinions about your care.
Your loved ones may also need a trusted person to guide them when they are facing impossible decisions. They may need help understanding your intent and advocating for your wishes if hospital staff pressure them toward a different choice.
This is one reason that when I work with you, I serve not only as your Personal Family Lawyer, but also as your trusted advisor throughout your life and as an advisor to your family if you become incapacitated or die.
Your loved ones will have a compassionate human being who knows you, understands your values and intentions, and can support them through an extremely difficult time with both legal and emotional guidance.
Book a 15-Minute Discovery Call to Start Your Plan
If the thought of being treated as an organ donor before you are truly gone makes you uncomfortable, you are not alone.
What happened to Anthony Hoover and others like him is tragic, but thoughtful planning can help reduce the risk of your family facing the same kind of uncertainty.
With a comprehensive Life & Legacy Plan, you can make your medical choices clear, protect your loved ones, and help ensure that no one has to wonder whether they made the right decision for you.
When you work with me, I will not only help you create your plan. I will also be available to guide your loved ones during an emergency and after your death.
During the first frantic hours or days in a hospital, when emotions are high and urgent choices must be made, your family will not be left alone to figure everything out. They will have someone to call who knows you, understands your values, and can help them move forward with clarity, compassion, and confidence.
Instead of facing an overwhelmed hospital system and a confusing stack of documents on their own, they will have a real person they can trust.
To learn more about how we can assist you and your loved ones, schedule a FREE discovery intake call using our online form, or call 501-300-7526 (PLAN) to schedule your FREE discovery intake call.
This article is a service of Phoenix Law, your trusted Arkansas Life & Legacy Planning and Arkansas estate planning attorneys in Sherwood, Arkansas. We do more than draft documents. We help you make informed and empowered decisions about life and death for yourself and the people you love. That is why we offer a Life and Legacy Planning Session, during which you can become more financially organized than ever before and make the best possible choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session.
This material was created for educational and informational purposes only and is not intended as ERISA, tax, legal, or investment advice. If you need legal advice specific to your circumstances, that advice must be obtained separately from this educational material.
