Should Doctors or Family Have Final Say over End-of-Life Medical Issues

After the recent dismissal of a case by the New Jersey Appellate Division, the question of whether or not hospitals have the right to overrule family wishes in Do Not Resuscitate (DNR) matters remains unclear.

The case in question involved the family of Ruben Betancourt and Trinitas Regional Medical Center of Elizabeth, NJ. The then 73-year-old Betancourt was in a vegetative state for more than a year when the hospital removed him from life-support equipment and sought to issue a DNR order. Betancourt’s daughter, Jacqueline, brought the case to court where she sought to become her father’s legal guardian and fought the hospital’s decision. The State Superior Court ruled in her favor; the hospital was ordered to put Betancourt back on life-support and the DNR order was removed. (1)

Trinitas appealed this decision, but Betancourt passed away before the State Appellate Division could rule on the case. Instead, the court dismissed the case at the request of Betancourt’s daughter. According to the court, the hospital failed to provide adequate evidence supporting its decision to stop life support efforts. Also, the court noted that Betancourt’s death made the matter in this instance moot. (2)

The question of when life support measures go beyond proper medical care has been debated in this State for more than 30 years, with one of the most notable cases being that of Karen Ann Quinlan. One of the issues that complicate this matter is determining the difference between dying and extremely ill and disabled. Another complication involves how long a person exists in the vegetative state. (3)

In the Betancourt case, the hospital contended that he was dying, while his family, on the other hand, believed he was responsive, noting that he sometimes turned in their directions or laughed at appropriate times.

While the State Superior Court decided that Betancourt’s daughter was a caring guardian with her father’s best interest at heart, the hospital contended that medical professionals, not family, should make medical decisions. (1)

Although the Appellate Division did not rule on this particular case, it did acknowledge the case’s far-reaching effects and asked the New Jersey State Legislature to clarify issues relating to end-of-life decisions for future cases. (4)

(1) https://en.wikipedia.org/wiki/Betancourt_v._Trinitas

(2) http://www.nj.com/news/index.ssf/2010/08/court_dismisses_appeal_filed_b.html

(3) http://www.northjersey.com/news/opinions/97784574_Uncomfortable_facts_in_end-of-life_case.html

(4) http://blog.nj.com/njv_editorial_page/2010/08/nj_court_rightly_urges_legisla.html