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Your Wishes for End-of-Life Care may be in Jeopardy

For those who take the time to plan for end-of-life treatment, their decision to do so is likely based on the desire to maintain control over what will happen to them in their final moments of life. Many individuals choose to sign a Do Not Resuscitate order for the purpose of directing medical professionals to refuse life-saving treatments in certain circumstances. These measures are often called "advance directives" and recent reports indicate that they may be ignored by medical professionals on a widespread level.

The Ledger recently reported that one heart-wrenching case of a Florida woman's dying wishes being ignored may actually be only the tip of the iceberg. The elderly woman had taken all recommended steps to plan for the end of her life, seeking to avoid "extraordinary measures" to keep her alive. These measures included a detailed living will and other documents appointing her daughter to express final wishes on her behalf, if she were unable to do so. Upon being admitted to the hospital in September 2011, she had completed and signed a DNR with her doctor. Despite the order, and against her clearly expressed wishes, the extraordinary measures she expressly sought to avoid in the documents were utilized at a nursing home and hospital. The woman's life was prolonged for several days against her wishes, and those expressed by her daughter on her behalf.

As the woman's daughter sat for five days, she held her mother's hand, and a ventilator kept her alive. At the time, she was unaware that her mother had a heart attack, which would have allowed her to have a clearer understanding as to how her mother's last wishes should have been carried out. When medical facilities ignore advance directives, the result often means an increase in the pain, expense, and grief surrounding the end of life. Even the act of CPR on a frail, elderly individual can be extremely painful, and can lead to a more difficult recovery.

Medical professionals that specialize in long-term care explain that issues like this will likely continue until better staffing and training are in place, so that communication between the workers, doctors and families can improve. The surviving daughter has initiated a medical malpractice lawsuit against the hospital, alleging that the failure to honor her mother's advance directive constituted negligence.

Ignored Advance Directives Believed to be Widespread

Unfortunately, this woman's case is not alone. Families for Better Care, a nonprofit group, reported that one-third of the citations for abuse or neglect in Florida nursing homes, that were considered to pose a danger to residents, involved disregard of advance directives. Although national studies are sparse, some also question whether such incidents are even reported as often as they happen.

Although this cautionary tale arises from Florida, its impact should be felt nationwide. New York as a large senior population-2.7 million in 2011 (approximately 13.7 percent of the total population), according to the HHS's Administration on Aging. According to the Henry J. Kaiser Family Foundation, New York has 107,480 residents in certified nursing facilities for the period of January 2011 through February 2012.

Under New York law, competent adults have a firmly established right to accept or reject medical treatment. This right includes the right to refuse medical interventions necessary to prolong the patient's life. When clearly expressed directives, refusing such treatment are ignored, medical malpractice liability may arise. If you are unsure about a claim involving these circumstances, contact an experienced medical malpractice attorney to assist you with your potential case.


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