Unmarried Partner Medical Decisions in Nevada: How to Get Legal Authority

Your partner of 15 years is rushed to the ER after a car accident. You arrive at the hospital. If your partner has not designated you as a healthcare agent, Nevada law does not automatically give you authority to consent to medical care.

Nevada's default surrogate hierarchy for decisions about withholding or withdrawing life-sustaining treatment, when no advance directive exists, follows a strict priority order: spouse; an adult child or majority of reasonably available adult children; parents; an adult sibling or majority of reasonably available adult siblings; the nearest other adult relative by blood or adoption; then an adult who has shown special care or concern, is familiar with the patient's values, and is willing and able to decide. An unmarried, unregistered partner is not automatically included in these listed classes.

Why Common-Law Marriage Does Not Help

Nevada does not recognize common-law marriage. No matter how long you have cohabited, shared finances, or presented yourselves as a couple, you are not legally married unless you obtained a marriage license and had a ceremony. This means the legal shortcuts available in states that recognize common-law marriage (like Colorado or Iowa) do not apply here.

Domestic partnerships registered with the Nevada Secretary of State do grant some healthcare decision-making rights, but the registration process requires a deliberate filing — it does not happen automatically by living together.

What Happens at the Hospital

For decisions about withholding or withdrawing life-sustaining treatment, the hospital follows the statutory surrogate hierarchy after the attending physician determines that the patient is in a terminal condition and no longer able to make those decisions. If your partner has adult children from a previous relationship, those children are ahead of an unregistered partner in the listed classes. If your partner's parents are alive and available, they come next; adult siblings follow them.

The hospital is not making a judgment call about the quality of your relationship — it is following Nevada law. A class with multiple family members must reach a majority; an evenly divided class does not pass authority to the next class, and the dispute may require district-court resolution. A separate HIPAA authorization and visitation authorization can help protect information access and visitation for an unmarried partner.

The Fix: Name Each Other as Healthcare Agents

An advance directive under NRS 162A.855 lets each of you designate the other as your healthcare agent. This designation is legally binding and overrides the default surrogate hierarchy. Your partner moves from having no automatic priority to having authority to make the healthcare decisions permitted by the directive and state law on your behalf.

Both partners should execute separate advance directives — one naming the other. Each document should also designate alternate agents in case both of you are incapacitated simultaneously (a car accident, for example).

To execute: each directive needs either notarization or two competent adult witnesses. The witnesses need not personally know the principal, but an owner, operator, or employee of a nursing home where the principal resides cannot serve as a witness. After signing, register both directives with the Nevada Secretary of State's free Lockbox so hospitals have 24/7 access.

Additional Documents to Consider

An advance directive covers medical decisions, but unmarried partners should also consider:

• HIPAA authorization: Grants your partner access to your medical records. Some hospitals include this in the advance directive form; others require a separate document.
• Hospital visitation authorization: Ensures your partner is treated as family for visitation purposes, particularly in ICU settings with restricted access.
• Financial power of attorney: A separate document (not part of the healthcare directive) that grants authority over financial decisions during incapacity.

These additional documents are especially important for unmarried couples because many automatic spousal protections do not apply.

Act Before the Emergency

The window for executing these documents closes when incapacity occurs. If your partner is already incapacitated without a directive, you cannot retroactively grant yourself authority through an advance directive. Depending on the decision and the available statutory surrogate, the family may need to use Nevada's surrogate process or seek a district-court resolution.

The Nevada Advance Directive & Living Will Kit provides the NRS 162A.855 form and witness eligibility checklist for both partners, so you can execute matching directives and ensure neither of you is locked out of the other's medical care.

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