Doctor's request to end patient's care denied

In the Courts. By Bonnie Booth, AMNews contributor. June 12, 2006.

There are few controversies in medicine that stir as much emotion as whether to withhold extraordinary measures being used to keep a seriously ill patient alive. Physicians and hospital ethics committees agree that in the best-case scenarios, patients have made those treatment wishes known, preferably in writing, in advance of becoming incapable of conveying them to others.

Failing that, they said, they hope for a consensus among relatives that the patient's condition is irreversible and for an agreement among them about what the patient would have wanted to happen next.

Physicians, nurses and others who treat patients at the end of their lives generally prefer to keep these decisions near the bedside and out of the courtroom.

Paul Hofmann, DrPH, president of the Hofmann Healthcare Group in Moraga, Calif., puts it most succinctly when he says: "The general preference is for not engaging judges or courts to begin with."

Michigan Judge Frank Willis takes no offense at hearing that his courtroom is a less-than-favored last resort for these kinds of decisions.

After all, he noted, decisions about whether to use extreme measures to extend life involve a lot of turmoil and affect him emotionally as well. But, he said, his job is to handle such cases, and he doesn't back away from the duty.

Willis, who is a probate judge in Van Buren County, recently found himself called upon, for the third time in his 25 years on the bench, to decide whether to withhold extraordinary measures being used to keep a seriously ill patient alive.