A cautionary tale...
We all have been victims of procrastination at one time or another. “Maybe I’ll set up my estate plan next week, or next month,” you think. “There’s no rush because I’m healthy, right?” you say. Unfortunately for one man, he didn’t have more time.
I came across this haunting account on the popular website, Quora, where users around the world can ask and answer questions. The question posed was “As a doctor or nurse, what's the saddest scene you have ever witnessed?”
The ordeal, as witnessed and retold by registered nurse Deb Georgens, began in the hospital’s neurosurgical intensive care unit. A man was wheeled in who had suffered an acute subdural hematoma after accidentally falling from a ladder while cleaning his gutters. Such an injury involves a buildup of blood near the brain, and if the pressure is not relieved in a timely manner, the pressure inside the skull can cause irreversible damage to delicate brain tissue, and is often life-threatening.
In this particular patient’s case, the hospital had enough time to prevent such catastrophic damage, if only the medical consent could be obtained for the doctors to perform a relatively simple procedure at the patient’s bedside to remove the blood clot. Nurse Georgens prepared the medical consent paperwork to authorize the hospital to perform the procedure. This was a situation where seconds mattered.
This is where the story takes a dark and unfortunate turn due to legal issues. The man was comatose and thus not able to provide consent for the procedure himself. Although the woman who accompanied him to the hospital had lived together with him for many years, they were never legally married, nor did they execute estate planning documents. Thus the patient’s domestic partner was unable to provide the necessary consent either. Because the patient did not have a health care Power of Attorney, the hospital followed the statutory procedure (a procedure established by law) for obtaining consent from the patient’s children. The hospital contacted the patient’s next of kin, his oldest child. Although the hospital expected the oldest child to provide consent and explained the gravity of the situation, this son chose to delay the decision, ostensibly in order to contact the man’s middle child to discuss the situation. When the oldest child telephoned the hospital back, instead of providing consent, he said that he and his siblings were coming to the hospital.This completely derailed the hospital’s attempt to use the administrative consent process which could only be used when no next of kin is available to sign: this patient had three children who were all on their way. Meanwhile, the patient’s partner of many years remained at his bedside, clutching his hand, stroking his face, and weeping. Over two hours passed by, and progressively greater amounts of brain damage ensued.
Finally, all three of the patient’s children showed up at the hospital together and proceeded into his room to congregate around his bed. Over his still living body, they bemoaned the possibility that if the patient were to recover, he might marry his partner and bequeath his house to her instead of leaving it to them. Thus they conspired against him, and it became apparent to the medical team that these children never intended to grant consent for the life-preserving operation and deliberately wasted precious time. It was then too late to obtain administrative consent, and the children left with the oldest saying “We’re not going to sign consent.” The medical team was horrified, and Nurse Georgens felt tremendous anger at the children’s callousness.
How could things have been different? If the man had established a well-drafted health care Power of Attorney (POA) prior to his accident, his partner could have consented to his surgery, thus paving the way towards recovery.
My firm, Inman Law PLLC, drafts a combination Advance Medical Directive and Appointment of Agent for Health Care Decisions (Healthcare POA). It is my recommendation that everyone have both of these documents in place to help clarify your wishes and protect you from the unforeseen. Appointing someone of your choice to make decisions for you if you become incapacitated could save valuable time, and lets you decide who you trust instead of you being at the mercy of statutory procedures.
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