The recent news coverage of the fight over who should make medical care decisions for Al Barnes is a reminder of the need for careful estate planning, generally, and particularly in drafting health care directives.
Minnesota law gives significant weight to written health care directives, but only when decision-makers who have been appointed request care that is reasonable by current medical standards. That can raise the potential for conflict, because doctors and relatives can disagree on the meaning of ‘reasonable.’ Disputes can be more common over end-of-life decisions.
Barnes, currently 85 years old, executed a written health care directive in 1993, appointing his wife, Lana, to make medical care decisions for him in the event that he became unable to do so himself. The recent dispute arose because Methodist Hospital was seeking to replace Lana because she was demanding treatment that doctors believed was futile and unethical.
Doctors maintained that Barnes’ level of dementia is so high that further treatment for kidney and respiratory failure made no sense and would be unethical. Lana Barnes disagreed with the doctors, arguing that Barnes was suffering from chronic Lyme disease, and that antibiotic treatment of the tick-borne bacterial infection would reverse his dementia — and necessitate treatment for his other conditions as well.
Ultimately, the Hennepin County Probate Court removed Lana Barnes as decision-maker for her husband. This was based, in part, on her admission that she had altered the health care directive by omitting two pages, as well as the revelation that Barnes had executed a second health care directive in 1994 which appointed his son as decision-maker in place of Lana.
The case is a reminder of the importance of clarity and the inclusion of appropriate detail in the instructions contained in health care directives. The directive should contain specific information about the person’s values and goals, so that their preferences regarding end-of-life care are fully known.
If you have questions regarding health care directives, contact an experienced attorney at our firm. We can guide you through these difficult decisions.
Source: “Case raises agonizing end-of-life questions,” Star Tribune, 1-31-11.