Elder Law

New Jersey Court Rules That Hospital Must Resume Life Support For Patient In Vegetative State

By dvanar

A Union County judge has ordered life support resumed for a patient who has been in a vegetative state for 14 months, restraining a hospital from taking it upon itself to discontinue or suspend treatment, and rejecting arguments that public health considerations take precedence over the patient?s family?s wishes.

Ruben Betancourt has been unconscious since suffering complications in an operation at Trinitas Regional Medical Hospital to remove a malignant thymus gland. The hospital maintained he does not respond to pain or move his extremities and only makes reflexive eye movements, and that continuing treatment is inhumane and contrary to standards of care. Betancourt’s family members, however, insisted he is responsive to stimuli. They say he recoils when approached by medical providers and opens his eyes or turns his head when he hears certain voices. In fact, notations on his chart by medical staff state that he has been observed to be “awake.”

On March 4th, Superior Court Judge John Malone ruled that life-support decisions should be made not by caregivers or courts but in accordance with a patient’s rights as expressed by a surrogate decision-maker.

The decision is important because the judge refused to adopt a novel position advanced by the hospital: that its doctors should not be forced to provide medical treatment that they believe is inhumane and contrary to standards of care. The hospital, relying in part on the out-of-state decision in Causey v. St. Francis Medical Center, 719 So. 2d 1072 (LA. App. 2d.Cir. 1998), argued there is a public interest in letting physicians provide what they consider quality care ? including “promoting dignity where death is inevitable and elevating the quality of life over longevity.” The hospital also cited Couch v. Visiting Home Care Service, 329 N.J. Super. 47 (App. Div. 2000), in which a New Jersey court said a home nursing care agency need not continue to treat a patient in a deteriorating condition that made it unsafe for him to live at home.

Judge Malone instead followed the New Jersey Supreme Court’s ruling in matter-of-jobes, 108 N.J. 394 (1987), which held the trial court’s role is not to decide on the removal of medical treatment but to respect the patient’s right to self-determination. Where the patient is unable to enunciate his wishes, the “substituted judgment” doctrine first enunciated in in_re_quinlan, 70 N.J. 10 (1976), requires the court to defer to a surrogate decision-maker. Judge Malone appointed Betancourt’s daughter, who wishes to continue life support, as his guardian.

Full post as published by Law Office of Donald D. Vanarelli Blog on March 11, 2009 (boomark / email).