Order at the End of Life: Establishing a Clear and Fair Mechanism for the Resolution of Futility Disputes
On January 22, 2008, Ruben Betancourt was admitted to Trinitas Regional Medical Center in New Jersey for surgery for malignant thymoma, a cancer of the thymus gland (a small organ underneath the breastbone).' Following surgery, the patient developed brain damage due to lack of oxygen and, as a result, lapsed into unconsciousness. For the next five months, Mr. Betancourt was admitted to various medical facilities and readmitted finally to Trinitas in July 2008 for renal failure. For six more months, the unconscious patient remained in the hospital on an artificial ventilator, receiving renal dialysis and nutrition through tube feeding.
The medical staff at Trinitas determined that Mr. Betancourt was in an unresponsive, irreversible vegetative state and that further treatment would be futile. As such, they recommended to the patient's family that life-sustaining treatment be discontinued. The family disputed the hospital's findings, claiming that the patient responded to certain stimuli. Namely, they insisted that the patient recoiled when approached by medical providers, responded by opening his eyes, and turned his head in response to certain voices. The family further described Mr. Betancourt as a "strong willed person who would not give up," thus leading them to believe that he would want to continue to receive treatment. As a result, the family insisted that the healthcare provider uphold this choice. What should the healthcare provider do in this scenario? If disagreement persists, how should the surrogate decisionmaker respond?
Order at the End of Life: Establishing a Clear and Fair Mechanism for the Resolution of Futility Disputes,
63 Vanderbilt Law Review
Available at: https://scholarship.law.vanderbilt.edu/vlr/vol63/iss2/4