Jamie M. Crist JD, MA
Critical care clinicians are legally and ethically obligated to identify the appropriate surrogate decision-makers for patients who lack capacity and cannot make medical decisions for themselves. When the identification of the appropriate surrogate is streamlined, patient care is improved due to an uninterrupted and consistent plan of care that adheres to patient preferences. However, the process of identifying this “appropriate” person can be complex, especially as interpersonal relationships have evolved over time. One such modern family relationship is informal marriage, a Texas-specific relationship formerly known as “common-law” marriage. Though crucially important, this relationship can be difficult to recognize and is frequently misunderstood.
Utilizing a case study, this paper seeks to show how an informal marriage can impact medical decision-making by outlining what makes a relationship an informal marriage and provides tools to assist clinicians with identifying it. In an age in which non-traditional relationships are more common, Texas critical care clinicians should be familiar with informal marriage and recognize it in their patients to efficiently identify surrogates and therefore improve patient care.
Keywords: informal marriage, common-law marriage, Texas, medical ethics, advance care planning, critical care
Article citation: Crist JM. Modern family: Texas critical care clinicians need to know about informal marriage. The Southwest Respiratory and Critical Care Chronicles 2020;8(34):73–76
From: Baylor College of Medicine, Center for Medical Ethics and Health Policy, Houston, TX; Houston Methodist Hospital; Biomedical Ethics Consult Service, Houston, TX
Submitted: 2/23/2020
Accepted: 4/7/2020
Reviewer: Steven Urban MD
Conflicts of interest: none
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