“Futile care” — the forced removal by doctors and hospital bioethics committees of wanted life-extending treatment over patient and family objections — is, alas, still the law of Texas. And now a hospital in Florida has sued for the right to do the same thing to Genea Bristol, age 41.
Here’s the bitter irony: Bristol is a nurse who contracted COVID caring for coronavirus patients in nursing homes and experienced severe lung damage. Now, she is threatened with losing her own life despite her own apparent views on such a decision and the wishes of her mother.
Here’s the story: Bristol’s doctors believe it is in her best interest to remove life-extending treatment. But Bristol’s mother refused. So, the administrators of Lawnwood Regional Medical Center sued to have a court order to terminate treatment. Treasure Coast Newspapers columnist Laurence Reisman explains:
There is no alternative, said Lawnwood’s attorney Blake Delaney of Tampa-based Buchanan, Ingersoll and Rooney. His petition included affidavits from Drs. Michael Bakerman, the hospital’s chief medical officer, and Sasha Boris Grek, one of Bristol’s physicians, who said she has an “irreversible COVID-19 lung injury,” is in “grave” condition and dependent on a machine that puts oxygen in her blood and a ventilator.
The hospital said it has tried to find a facility where a lung transplant can be done, but they’ve been told she is not a suitable candidate. There are no other treatments.
The physicians have recommended stopping their aggressive treatment because her condition is “unlikely to experience any significant clinical improvement” and think her condition is irreversible.
Please understand what these medical experts are claiming — that Bristol’s life itself is “futile.” But that isn’t a “medical” question. It is a values judgment.
That’s the huge danger in these “futile care” cases. Bioethicists and doctors impose their own quality-of-life ethics on patients that they and/or their families do not accept.
Bristol’s mother says that her daughter would want to continue living:
Her mother said Genea made her wishes clear the night she went to the hospital. “She said, ‘Mom, I need you to make them (health care workers) responsible and do everything for me.’ I promised her I would,” Belinda Bristol told me in February.
Reisman summarizes the competing court claims:
[Hospital lawyer] Delaney said this is an especially complicated case because Genea needs to be hooked up to an extracorporeal membrane oxygenation (ECMO) machine she can’t just take home.
“There are competing interests here,” Delaney said. “Every medical provider has the right to insist on not providing futile care. … You have to see the context … You can’t just look into what the patient wants.”
Florida statutes suggest otherwise, [family lawyer] Anastasio said, noting the Florida and U.S. supreme courts have talked about a “presumption of life” when there’s any question.
“When in doubt, you have to presume they want life,” Anastasio said. “I wouldn’t want to have it any other way.”
The judge has, so far, sided with the family, requiring the hospital to reframe its pleadings. Noting the Texas futile-care law does not apply in Florida (full disclosure, I testified twice in front of Texas legislative committees last month urging the futile-care statute’s repeal) the judge said:
“We are not Texas,” she said. “It is ultimately going to be what the patient did want . . . if the patient made that clear.”
If not, the court likely would do what’s in the best interest of the patient.
Based on Lawnwood’s petition, [Judge] Buchanan suggested hospital officials know what the patient wants.
If that is so, they apparently think their “expert” values should trump the desires of patient and family about one of the most intimate and consequential decisions about health care that people make.
This is an important case. Thanks to Reisman for giving this story the attention it deserves, demonstrating the crucial role local media play in our public affairs.