The Institute of Consultative Bioethics

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Who Decides?

Written by: Dr. Kathy Gennuso

A fragile 85-year-old admitted to the hospital of a large medical center needs and expects more than limited access to and comfort from her daughter. Unfortunately, not happening—according to the Pittsburgh Post-Gazette.

The daughter, actively advocating for her mother, explained, “I didn’t consent, after consulting Mayo Clinic, to some risky, questionable, no-evidence-based medical procedures and experimental treatments . . . .”  The hospital reacted to the daughter’s manner of disagreement, her input regarding care, her statement relating her mother’s expressed wishes for treatment, or possibly all three.  Then, the article continues, her visits were disallowed unless hospital invited or for emergency (required). Furthermore, the hospital went to court and power of medical attorney for the mother was granted to Ursuline Senior Services, as the guardianship statute allows courts to do.

Really?! It’s out-of-bounds to vigorously disagree with a loved one’s medical plan, especially when it violates expressed wishes? What must diligent advocates do?  OK, maybe not the whole story, but . . . reportedly, the daughter’s visitation time’s been curtailed: 3-weekly, 30-minute visits. She must report to hospital security, submit to metal detection and escorts.

Hopefully, Post-Gazette didn’t unwittingly overstate the seriousness, nor mistake the details, while painting this distressing picture. If not, I have to wonder: who made this medical center’s series of high-impact decisions here. . . and how?

Shout-out to hospitals without formal ethics program in place:

Is now the time to reconsider whether or not having one is a necessity?