Many health care providers have dealt with guardianships, or conservatorships, in which courts appoint a guardian who serves as the decision maker for someone who isn’t capable of self-care or decisions, including medical, dental or health care services. This legal tool can be important for protection of patients, who may need medical intervention or care but may be unable to ask for or arrange it.

This year, the legal battles of pop singer Britney Spears have put guardianships in the media spotlight. Britney is objecting to the control that her father is exerting over her life – claiming she is fully capable of making decisions and that her father is interfering with her medical autonomy.

For health systems of all sizes, the issues around mental hygiene and guardianships have never been out of focus. Particularly during the COVID-19 pandemic, mental health patient volume has shattered previous highs, but fewer beds are available.