Representative Melody Cunningham introduced House Bill 825 to create a statutory mechanism allowing an individual to designate a ‘‘trusted decision maker’’ by informing a clinician while the patient still has decision‑making capacity. The designation would be recorded in the medical chart and, when present, would enter the statutory hierarchy of surrogate decision makers when a patient later lacks capacity.

Nut graf: Supporters said the change would fill practical gaps for patients who have not completed formal advance directives or durable powers of attorney but who, when hospitalized, can identify someone they trust to make decisions. Clinicians and palliative‑care physicians told the committee the option would reduce delay, confusion, and the burden of trying to complete notarized documents in the short window before patients lose capacity.

Proponents included the Montana Medical Association and the Montana Academy of Family Physicians. ‘‘If something happened to a person who does not have a durable power of attorney, it’s helpful to have a clear hierarchy and a recorded trusted decision maker,’’ Stacy Anderson of the family physicians’ group said. Christopher Johns, a palliative care physician, described clinical examples where a neighbor or close friend — not a listed next of kin — was the person best able to represent a patient’s values.

The bill does not supersede a completed advance directive or durable power of attorney. Representative Cunningham said the trusted decision maker is intended as an interim option recorded in the chart and that clinicians retain the duty to seek durable documentation when possible.

Action: The committee advanced House Bill 825 to the floor; the roll call recorded 21 ayes and a small number of nays on final passage in committee.

Ending: The bill proceeds to the House floor with support from physician groups and palliative care clinicians, and with committee direction to preserve the primacy of signed advance directives while allowing clinicians a clear, recorded exemplar of the patient’s wishes when time or circumstances prevent formal paperwork.