In some legal systems, rights regarding inheritance (which imply a decision-making capacity — for example, in a medical emergency — where no clear will or instructions have been given, and where the person has no spouse) flow to the closest relative (regardless of the age, with a representative appointed if a minor), usually a child, a parent or a sibling.
However, there are people without any close adult relatives and, in such a case, decision-making power often flows to a niece or nephew, first cousin, aunt or uncle, or grandparent.
The status of next-of-kin confers no legal rights and has no special responsibilities, except as referred to below in the specific context of the Mental Health Act.
[7] In the context of health care, patients are often asked to nominate a next-of-kin when registering with their general practitioner, or alternatively on admission to hospital.
If the patient is unconscious or otherwise unable to state their next-of-kin, hospitals will usually list their nearest blood relative, though there are no specific rules.
Doctors attempt to seek the views of the next-of-kin when considering decision making for unconscious patients or those who lack capacity.
[8] As a result of these social changes, the policy in most NHS trusts is to ask a person on their admission to hospital to nominate their next of kin formally.
If a patient is incapable of making a decision (for instance due to unconsciousness), the present medical ethics in Ireland is to consult with the next of kin (in order: spouse, children, parents, siblings).