Alaska Court to Address Merits of Medical Futility Dispute
Posted Sep 22 2008 5:59am
Last Thursday, the Alaska Supreme Court ruled that the appropriate guardian in the Mari Chamberlain case is the state guardian. It remanded the case to the superior court, noting that either of two things must happen:
1. The guardian opposes the providers' recommendation to stop LSMT. In that case, the superior court must construe the language in Alaska Statute 13.52.060(e) and (f), which is the standard Uniform Health Care Decisions Act language:
(e) A health care provider may decline to comply with an individual instruction or a health care decision for reasons of conscience, except for a do not resuscitate order. A health care institution or health care facility may decline to comply with an individual instruction or health care decision if the instruction or decision is contrary to a policy of the institution or facility that is expressly based on reasons of conscience and if the policy was timely communicated to the patient or to a person then authorized to make health care decisions for the patient.
(f) A health care provider, health care institution, or health care facility may decline to comply with an individual instruction or a health care decision that requires medically ineffective health care or health care contrary to generally accepted health care standards applicable to the provider, institution, or facility. In this subsection, "medically ineffective health care" means health care that according to reasonable medical judgment cannot cure the patient's illness, cannot diminish its progressive course, and cannot effectively alleviate severe discomfort and distress.
2. If the guardian agrees with the providers' recommendation, then Mari Chamberlain's family can challenge that decision as exceeding the scope of a guardian's authority under Alaska Statute 13.26.150(e)(3):
A guardian may not . . . (3) consent on behalf of the ward to the withholding of lifesaving medical procedures; however, a guardian is not required to oppose the cessation or withholding of lifesaving medical procedures when those procedures will serve only to prolong the dying process and offer no reasonable expectation of effecting a temporary or permanent cure of or relief from the illness or condition being treated unless the ward has clearly stated that lifesaving medical procedures not be withheld . . .