But even if you had a single "designated person" it probably wouldn't make any difference. Any person that you contacted could call and once the Coast Guard has been alerted the process will begin. I don't think the USCG recognizes "Advance Directives" or "Living Wills". I doubt that the cutter had any real options left once the process had begun, other than remove him. The potential for lawsuits and unfavorable press. Just imagine how CNN would play it. The moral seems to be don't talk to anyone after you leave port unless you are in real trouble and want to get unassed. Good friends will get you in trouble with the best of intentions.