Betancourt v. Tinitas Hospital is now pending before the Appellate Division of the New Jersey Superior Court. Trinitas Hospital is appealing a March 2009 trial court injunction, ordering its physicians to continue providing life-sustaining medical treatment (particularly dialysis) that these providers judged to be medically inappropriate and outside the standard of care.
In early 2009, patient Ruben Betancourt was in a permanent vegetative state with multi-organ failure and slim prospects for recovery. Still, the patient’s daughter, Jacqueline, would not accede to recommendations to stop dialysis and switch to palliative care. When it became apparent that providers might unilaterally withdraw Mr. Betancourt’s life-sustaining treatment, Jacqueline sought injunctive relief. In March 2009, the trial court issued a final order appointing Jacqueline as guardian, and requiring Trinitas Hospital to continue the life-sustaining treatment.
New Jersey has long been the “proving ground” for healthcare law at the end of life. This case squarely and explicitly presents the core medical futility question: “Must physicians provide life-sustaining treatment they think medically inappropriate just because it is requested by the patient’s substitute decision maker?” The Betancourt case is unique and important. Almost all previous futility cases were framed in far more narrow and coincidental ways, in terms of EMTALA, for example. Therefore, this case may provide much-needed and much-wanted guidance not only in New Jersey but also across the United States and beyond.
Accordingly, the case has attracted amicus briefs from, among others: the New Jersey Hospital Association, the Catholic Healthcare Partnership of New Jersey, the Medical Society of New Jersey, Not Dead Yet, ADAPT, New Jersey Physicians, the Greater New York Hospital Association, Agudath Israel of America, and the Union of Orthodox Jewish Congregations of America.
In this amicus curiae brief, law professor Thaddeus Pope supports the position of Plaintiff/Respondent Jacqueline Betancourt. He argues: (1) that the disputed treatment is within the standard of care, (2) that in any right to refuse critical care treatment is conditioned on transferring the patient, (3) that the New Jersey advance directives act is irrelevant to the dispute since the patient did not have an advance directive, (4) that Jacqueline is the appropriate guardian, and (5) that New Jersey statutory and Supreme Court authority forbid the judicial creation of a new internal dispute resolution mechanism making the hospital’s own ethics committee a forum of last resort.
- medical futility,
- death and dying,
- advance directives,
- patient abandonment,
- refusal of treatment
Available at: http://works.bepress.com/thaddeus_pope/31/