Modern family: Texas critical care clinicians need to know about informal marriage

  • Jamie Crist Baylor College of Medicine


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 is can difficult to recognize and frequently misunderstood.

Utilizing a case study that illustrates the impact the existence of an informal marriage has on medical decision-making, this paper seeks to demystify informal marriage by outlining what makes a relationship an informal marriage and provide tools to assist clinicians with identifying it.  In an age where non-traditional relationships are more common, Texas critical care clinicians should be familiar enough with informal marriage to recognize it in their patients in order to efficiently identify surrogates and therefore improve patient care.


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How to Cite
Crist, J. (2020). Modern family: Texas critical care clinicians need to know about informal marriage. The Southwest Respiratory and Critical Care Chronicles, 8(34), 73-76.