.. ..: 4 .. NCSC HF 38-27 E87 M Y \\Resolving Disputes Over C,3 Life-Sustaining Treatment \I A Health Care Provider's Guide Thomas L. Hafemeister ani Paula L. Hannaford Wth the Greenwall Coordinating Council National Center for State Courts library National Center for State Courts 300 Newport Ave. WJliamsburg, VA 23 187-8798 0 1996 National Center for State Courts Williamsburg, Virginia Library of Congress Catalog Card Number 96-70341 ISBN 0-89656-167-4 NCSC Publication Number R- 186 Cover design by Judith Ann Sullivan Images 0 1996 PhotoDisc, Inc. This book was prepared under a grant from the Greenwall Foundation. The points of view expressed are those of the authors and do not necessarily represent the official position or policy of the National Center for State Courts or the Greenwall Foundation, or the opinions of the Greenwall Review Panel members. Comments are welcome and should be sent to the Greenwall Project, National Center for State Courts, 300 Newport Avenue (231851,PO. Box 8798, Williamsburg, VA 23187-8798. Greenwall Coordinating Council Hon. Stewart G. Pollock, Chair New Jersey Supreme Court Morristown, New Jersey Hon. Elizabeth B. Lacy, Vice-Chair Virginia Supreme Court Richmond, Virginia Hon. Robert C. Bibb (ret.) Alexander M. Capron, J.D. Deno, Millikan, Dale & Decker Professor of Law & Medicine Everett, Washington University of Southern California Law Center hsAngeles, California Ellen B. Comer, Esq. Ronald E. Cranford, M.D. Dilworth, Paxson, Kalish & Kauffman Department of Neurology Philadelphia, Pennsylvania Hennepin County Medical Center Minneapolis, Minnesota Norman Fost, M.D., M.P.H. Hon. Hilda R. Gage Professor Chief Judge, Michigan Circuit Court Pediatrics & History of Medicine Pontiac, Michigan Director, Program in Medical Ethics University of Wisconsin Medical School Joan McIver Gibson, Ph.D. Madison, Wisconsin Consulting Ethicist Albuquerque, New Mexico Alan Meisel, J.D. Kathryn Moseley, M.D. Professor of Law and Bioethics Department of Pediatrics School of Law Henry Ford Hospital University of Pittsburgh Detroit, Michigan Pittsburgh, Pennsylvania John H. Pickering, Esq. Colleen Scanlon, R.N., M.S., J.D. Wilmer, Cutler & Pickering Director Washington, D .C . Center for Ethics & Human Rights American Nurses Association Washington, D.C. Susan M. Wolf, J.D. Associate Professor of Law & Medicine University of Minnesota School of Law Center for Biomedical Ethics Minneapolis, Minnesota VVilliam §tubing President Greenwall Foundation New York, New York National Center for State Courts Project Staff mCdOlr E. Phgo, Ph.D. Thomas L. Hafemeister, J.D., Ph.D. Project Director 119951996] Project Director ( 1993-1995) Pamela M. Casey, PkD. Paula L. Hannaford, J.D., M.P.P. Associate Director, Research Research Analyst Joshua E Stump Lisa Ghee Research Assistant Project Secretary jacquenine J. ~ncpven;]P~.D. Hngo Keilitz, Ph.D. Office of Ethics Sherwood Associates Children’s National Medical Center Williamsburg, Virginia Washington, D.C. Pam Lambert, MA., J.D. Joanne Lynn, M.D. Staff Attorney Center to Improve Care of the Dying Center for Health Law & Ethics George Washington University Institute of Public Law Medical Center University of New Mexico Washington, D.C. Albuquerque, New Mexico Christine Mitchell, M.S.N. Hon. Francis G. Poitrast Program in Ethics and the Professions Presiding Justice Harvard University Juvenile Court Department Cambridge, Massachusetts Boston, Massachusetts Greenwall Review Panel Members Frederick R. Abrams, M.D. Hon. Douglas K. Amdahl Denver UniversityKolorado University Chief Justice (ret.] Health Ethics and Policy Consortium Minnesota Supreme Court Denver, Colorado Minneapolis, Minnesota Hon. Joseph F. Baca David Bennahum, M.D. Chief Justice UNM Health Sciences Center Supreme Court of New Mexico Albuquerque, New Mexico Santa Fe, New Mexico Robin Borges, R.N. Richard Bourne, J.D., Ph.D. First American Home Care Office of General Counsel Hampton, Virginia Children’s Hospital Boston, Massachusetts Leslie Bricker, M.D. Andrew Broder, Esq. Henry Ford Hospital Vlcko, Lane, Payne & Broder Detroit, Michigan Bingham Farms, Michigan Dennis Brodeur, Ph.D. Frederick W. Brown, Jr. SSM Health Care System Ethics Consultant St. Louis, Missouri Northampton, Massachusetts Susan Fox Buchanan, Esq. Elizabeth L. Buff Colorado Collective for Medical Far Hills, New Jersey Decisions and Consortium on Health Ethics and Policy Alexa Canady, M.D. Denver University and Chief of Neurosurgery University of Colorado Children’s Hospital of Michigan Denver, Colorado Detroit, Michigan Arthur L. Caplan, Ph.D. Eileen Chichin, D.S.W., R.N. University of Pennsylvania Center on Ethics in Geriatrics and Medical Center Longterm Care Philadelphia, Pennsylvania New York, New York Phyllis Chinlund, C.S.W. Myra Christopher Geriatric Outreach Program President The Jewish Home & Hospital Midwest Bioethics Center for the Aged Kansas City, Missouri New York, New York Ellen Wright Clayton, M.D., J.D. Nancy Coleman Vanderbilt University Commission on Legal Nashville, Tennessee Problems of the Elderly American Bar Association Washington, D.C. Sheila Contneetn, M.S.N., A.N.B. Nelia Davis, R.N., M.S.N. Program Director Clinical Nurse Specialist, Gerontology Hospital Based Home Care Sentara-LeighHospital VA Medical Center Norfolk, Virginia Albuquerque, New Mexico Kenneth De Ville, Ph.D., J.D. Martin E. Doerfler, M.D. School of Medicine Director of Critical Care Medicine East Carolina University N.Y.U. Medical Center Greenville, North Carolina New York, New York Terry Donnelr, B.S.N., J.D. Nancy N. Dubler, LL.B. Health Care Law & Risk Managemc:nt Director of the Division of Bioethics Consultant Montefiore Medical Center Adjunct Faculty, Ursuline College Bronx, New York Cleveland, Oh0 Horn. Christine M. Durham Linda Emanuel, M.D., Ph.D. Utah Supreme Court Assistant Director Salt Lake City, Utah Division of Medical Ethics Harvard Medical School Ezekiel EmanmeB, M.D., Ph.D. Boston, Massachusetts Brookline, Massachusetts Rick Elrickson Hon. Ralph Erickstad Director of Pastoral Services Chief Justice (ret.] St. Mary’s Health Center North Dakota Supreme Court St. Louis, Missouri Bismark, North Dakota 6. Douglas Perghlscpn, Esq. Joseph J. Fins, M.D. Anderson & Hunter The Hastings Center Everett, Washington Briarcliff Manor, New York Joseph Fischofd, M.D. John C. Fletcher, Ph.D. Chair, Ethcs Committee The Center for Biomedical Ethics Children’s Hospital of Michigan Charlottesville, Virginia Detroit, Michigan Keith Ghezzi, M.D. John Glasson, M.D. George Washington University Council on Ethical and Judicial Affairs Medical Center American Medical Association Washington, D.C. Durham, North Carolina Hon. David Gdfitlin Amy Haddad, R.N., Ph.D. Magistrate, Probate Court Center for Health Policy and Ethics Colorado Springs, Colorado Creighton University Omaha, Nebraska Eunice Halverson James M. Hoefler, Ph.D. Director, Risk Management Associate Professor, Political Science, St. Mary’s Health Center and Coordinator of the Policy St. Louis, Missouri Studies Program Dickmson College Carlisle, Pennsylvania Diane E. Hoffmann, Esq. Fr. Jim Huth Assistant Professor of Law St. Joseph Healthcare System University of Maryland Albuquerque, New Mexico Baltimore, Maryland Sandra H. Johnson, Esq. Mary Gardiner Jones Center for Health Law Studies President St. Louis University Consumer Interest Research Institute School of Law Washington, D.C. St. Louis, Missouri Rev. Gail Joralemon Kathryn Kaminsky President Clinical Nurse Specialist New Mexico Health Decisions Psychiatry Consult Service Albuquerque, New Mexico University Hospitd Albuquerque, New Mexico Barbara S. Kellman, Esq. Wai LaMora, M.S.S. General Counsel First American Home Care New England Deaconess Hospital Newport News, Virginia Boston, Massachusetts Lauren Laughlin, Esq. Craig Lawson, Esq. staff Counsel, Probate Court College of Law St. Petersburg, Florida University of Nebraska Lincoln, Nebraska Steven A. Levenson, M.D. Charles Lewis, M.D. Director, Medical Services San Diego Hospice Asbury Methodist Village San Diego, California ‘ Gaithersburg, Maryland John J..Lombard, Jr., Esq. Susan R. Martyq, Esq. Morgan, Lewis & Bochus College of Law Philadelphia, Pennsylvania University of Toledo Toledo, Oh10 Barbara Mathis, Esq. Nancy Maxwell, Esq. Medical Staff Affairs O’Brien, Tanski, Tanzer, &Young UNM Health Sciences Center Hartford, Connecticut Albuquerque, New Mexico Phyanis McNanngBnten, M.S.W. Helene Meyers, M.P.A. Discharge Planning & Counseling Senior Vice President/COO/ Memorial Hospital Administrator Colorado Springs, Colorado The Jewish Home & Hospital for the Aged New York, New York Vncki Michd, M.A., J.D. Steven Miles, M.D. Los Angeles, California Center for Biomedical Ethics Minneapolis, Minnesota Dormand IMnnnphx M.D. Bunny Nedry, R.N. Presbyterian-St. Luke’s Hospital/ San Diego Hospice Senior Center San Diego, California Denver, Colorado Won. Linda K Nenmana Sherwin B. Nuland, M.D. Iowa Supreme Court Clinical Professor of Surgery Davenport, Iowa Yale School of Medicine New Haven, Connecticut E&ln OISQn,M.D. David Qrentlicher, M.D., J.D. The Jewish Home & Hospital Associate Professor of Law and Adjunct for the Aged Associate Professor of Medicine New York, New York Indiana University Indianapolis, Indiana Rev. Doug Overall John Barker, M.D. Pastoral Care Eastern Virginia Medical School Denver General Hospital Norfolk, Virginia Denver, Colorado Polly Wrsonms, M.D. John POpOVkh, IV%.D. Pulmonology-Department of Medicine Pulmonary & Critical Care Medicine Denver General Hospital Henry Ford