When you’re treating an 89-year-old incapacitated man with brain cancer, but the kids can’t agree about the kind of care he should get, what do you do? You have two courses to take. If he has a legal health care proxy, follow his designee’s reasonable decisions. If he does not have a health care proxy, the Maryland Health Care Decisions Act (HCDA) shows the way.
The HCDA clarifies the roles and responsibilities of everyone involved. If Dad’s spouse is alive, the HCDA gives her the exclusive authority to make decisions. If she isn’t, or if she can’t make decisions, Dad’s kids make the decisions. If they all agree, no problem. But if they disagree, you must refer the case to a facility Ethics Committee.
Let’s say the patient was a candidate for palliation, and would not benefit from any care at all. In such cases, the HCDA permits a physician to certify a patient as “terminal” – with a second physician’s certification – and to withhold medically futile care. In that case, even if the family wants herculean efforts, care does not have to be rendered if two physicians certify it as lacking medical benefit. And if the family wants a transfer to another facility, the HCDA requires reinstitution of care, pending transfer.
Bottom line: when the disagreements start, you don’t have to guess. The HCDA provides the answers. Contact us if you want to discuss this or similar issues related to medical malpractice and defense!