Legal Aspects Of Health Care Administration 11th Edition by George Pozgar

Exercise 2

Facts
Martin sustained debilitating injuries as the result of an automobile accident. His injuries left him totally paralyzed on the left side. He could communicate to a very minimal degree through head nods.
The trial court determined that Martin did not have nor would he ever have the ability to have the requisite capacity to make decisions regarding the withdrawal of life support equipment. Evidence demonstrated that Martin's preference would have been to decline life support equipment given his medical condition and prognosis. The trial court's decision was based on the following four-part test for determining whether a person has the requisite capacity to make a decision: whether the person (1) has sufficient mind to reasonably understand the condition, (2) is capable of understanding the nature and effect of the treatment choices, (3) is aware of the consequences associated with those choices, and (4) is able to make an informed choice that is voluntary and not coerced. The trial court determined that the spouse was a suitable guardian for Martin.
Mrs. Martin petitioned to withdraw her husband's life support. Martin's mother and sister counter- petitioned to have Mrs. Martin removed as the patient's guardian.
Issue
Was there sufficient evidence to support a finding that: (1) the patient lacked capacity to make decisions regarding the removal of life-sustaining treatment; (2) the patient would have had a medical preference to decline life-sustaining treatment under the circumstances; and (3) Mrs. Martin would be a suitable individual to represent her husband as to the withdrawal of life-sustaining medical treatment?
Holding The Michigan Court of Appeals held there was sufficient evidence to support a finding that: (1) the patient lacked capacity to make decisions regarding the withholding or withdrawal of life-sustaining treatment; (2) the patient would have declined treatment under the circumstances such as those that occurred; and (3) there was sufficient evidence to show that the patient's spouse was a suitable guardian.
Reason
The test for determining whether Martin had the requisite capacity to make a decision regarding the withholding or withdrawal of life-supporting medical treatment was clear and convincing. It was the general consensus of all of the experts that Martin's condition and cognitive level of functioning would not improve in the future.
Testimony from two of Martin's friends described statements made by him that he would never want to be maintained in a coma or in a vegetative state. In addition, Mrs. Martin described numerous statements made to her by Martin prior to the accident that he would not want to be maintained alive given the circumstances described here. The trial court found that Mrs. Martin was credible. The court of appeals found no reason to dispute the trial court's finding as to Mrs. Martin's credibility.
Contrary to allegations made by the patient's mother and sister, the evidence was clear that Mrs. Martin's testimony was credible. There was no evidence that Mrs. Martin had anything but her husband's best interest at heart. There were allegations, but no evidence, of financial considerations or pressure from another individual that would indicate that Mrs. Martin's testimony was influenced by other individuals.
Should the concern of the mother and sister have carried more weight in removing custody from Mrs. Martin?.