INDIANAPOLIS (Legal Newsline) - An Indiana hospital has defeated the lawsuit of a family upset that it provided life-prolonging care to their 91-year-old mother whose living will had do-not-resuscitate provisions.
The Estate of Joyce Gillette alleged Franciscan Health Indianapolis committed battery by keeping Gillette alive while her children argued over whether she should be allowed to pass naturally.
The Indiana Court of Appeals on Aug. 21 ruled the DNR provisions did not apply to Gillette's stay at Franciscan and noted one of her children (out of the four present) consented to the placement of a feeding tube.
"Because Stephen - an adult child - had coequal decision-making authority and because Stephen consented to placement of a feeding tube, we conclude Provider could not be liable for battery by attempting to place a feeding tube after Stephen provided consent," the decision says.
"In short, Stephen's unilateral consent was valid under the circumstances and the states then in effect, vitiating the prior refusal of further care for Joyce."
Joyce Gillette was 91 years old and receiving in-home hospice care in February 2017. She was unable to speak but had a certificate from her attending physician stating she suffered from a terminal illness and treatment of its symptoms "is considered appropriate."
When Gillette struggled to breathe during dinner on Feb. 23, 2017, the family told emergency responders she "was a DNR" but did not produce a document outlining those provisions. At Franciscan, she received emergency care, and the family produced the DNR document.
It stated she should be permitted to die naturally with treatment to alleviate pain and, if she indicated, artificially supplied nutrition and hydration. Joyce agreed not to receive that nutrition and hydration if "the effort to sustain life is futile or excessively burdensome."
A nurse determined the DNR provisions didn't apply to her breathing problems and she was placed on a ventilator. Four of her children "argued and argued," with a fifth in Florida and unreachable. Stephen was the only one of her children who wanted her to be kept alive until the child in Florida could make it to the hospital.
The family decided only to have Gillette on a ventilator until that daughter could travel there, and the next day a woman who said she was a social worker asked Stephen if they could place a feeding tube. He consented, but the effort failed.
Gillette was eventually taken off of the ventilator and died on Feb. 28.
"In Joyce's living will, she did unconditionally refuse life-prolonging care," the court ruled. "Rather, consistent with the living will declaration for provided in (Indiana law), the DNR provisions in Joyce's living will apply only if there is an eligible written certification from her attending physician."
And that certification noted that palliative care was appropriate, the court noted.
"Here, Dr. Pike's certification - focused on improving Joyce's quality of life - is not equivalent to a certification (that) 'the use of life-prolonging procedures would serve only to artificially prolong the dying process.'"