Appeals Court rules guardians have power to end life support

The Minnesota Court of Appeals ruled today that a guardian can authorize the disconnection of life-support systems without the intervention of the courts in Minnesota.

The court ruled in the case of Jeffers Tschumy, a 53 year old man with no family who suffered from diabetes, effect of a stroke and partial paralysis from a spinal infection. A professional guardian was appointed in 2009 and when Tschumy suffered irreversible brain damage in April 2012, his guardian directed Abbott Northwestern Hospital to remove life-prolonging treatment.

Abbott’s hospital ethics committee agreed that Tschumy was unlikely to recover and favored removing him from the equipment, but claimed the guardian didn’t have the specific power to make the decision. A district court agreed, ruling that although Minnesota grants broad power to guardians to consent to medical treatment on behalf of people, it doesn’t grant them the power to terminate life support. It also said most guardians received no training dealing with end-of-life issues and expressed concern that some guardians “may act irresponsibly.”

“No one — not even a judge — can look into the future and into the hearts and minds of a guardian to know with confidence that he or she will decide appropriately when, and if, an end-of-life decision needs to be made,” Hennepin County District Judge Jay Quam wrote.

Today, the Court of Appeals overturned that interpretation. “Although courts are experienced in making reasoned and impartial decisions, doctors and medical-ethics committees have the most appropriate knowledge and expertise to evaluate the potential for a ward’s long-term recovery and quality of life and advising a guardian on end-of-life decisionmaking,” Judge Natalie Hudson wrote in her decision. “Imposing a requirement for additional court involvement in this process would be inconsistent with the supreme court’s recognition of a private, medically based model of decisionmaking.”

Judge Hudson said today’s ruling doesn’t preclude an interested person from seeking a court review of a guardian’s decision to discontinue life support by asking a court to remove a guardian from the role.