Bentancourt v. Trinitas, New Jersey

If you haven't been following the end-of-life rights case in New Jersey, you can catch up on the developments at Thaddeus Pope's Medical Futility Blog. He presented to the court and is posting related materials at his site. From Saturday's post, an online letter from the New Jersey Hospital Association:

A three-judge panel heard arguments this week in Betancourt v. Trinitas Regional Medical Center, which involves important end-of-life issues. In addition to legal counsel for Trinitas, arguments were heard from NJHA, the Catholic Healthcare Partnership of New Jersey and the Medical Society of New Jersey, which together submitted a friend-of-the court brief on behalf of Trinitas.

The case involves an appeal by Trinitas from a lower court order which effectively compelled healthcare professionals to provide life-sustaining medical treatment (in this instance, kidney dialysis) indefinitely to a dying patient in a permanent vegetative state, despite medical professionals having determined that the treatment was not medically justified and was against the standard of care.

The appellate court heard oral argument for approximately 90 minutes. John Zen Jackson, from the law firm of Kalison, McBride, Jackson and Robertson, presented the case for NJHA, CHPNJ and MSNJ. Questions from the judges reflected a disparity of views. The principle of patient self-determination and autonomy was emphasized by one, while another appeared to question whether that principle alone was sufficient to compel the hospital and its physicians to continue providing care beyond a point that they believed was appropriate. The court also asked questions about the process for making decisions regarding end-of-life treatment and the role of the family and non-medical persons. NJHA’s joint brief suggested a process for resolution of such disputes, including internal hospital reviews and a procedure for transfers to a different healthcare facility.

Another aspect of the case is whether it should be considered at all by the court in light of the death of the patient as the appeal was being filed, and the lack of interest on the part of his family in continuing to litigate the matter. Jackson, among others, noted that the issue could recur and needed to be addressed now, rather than at a later time.