Many Georgia residents do not wish to receive extraordinary medical procedures in the event they are suffering from a terminal illness. Hospitals and health care providers are legally required to honor a patient’s wishes in this respect, especially when there is an Advance Directive making such intentions clear. If a hospital ignores such a directive, it may be liable for causing the patient unnecessary pain and suffering.
Doctors Hospital of Atlanta v. Alicea, Administratrix
The Georgia Supreme Court recently addressed the subject of when a hospital may escape liability for ignoring a terminal patient’s Advance Directive. The case is a pending lawsuit involving a 91-year-old woman who passed away in 2012. The plaintiff is the woman’s granddaughter, acting as the administratrix of her estate.
The decedent had an Advance Directive appointing her granddaughter as agent to make health care decisions for her in the event that she became unable to do so herself. The granddaughter said her grandmother expressly told her that she “did not want…to rely on a machine to have live,” such as a ventilator. More to the point, the Advance Directive contained an express declaration that, “I do not want my life to be prolonged if I have an incurable and irreversible condition that will result in my death within a relatively short time.”
In February 2012, the decedent was admitted to an Atlanta hospital, where she was diagnosed with pneumonia and acute renal failure. The granddaughter was present and gave hospital officials a copy of her grandmother’s Advance Directive. The granddaughter also repeatedly emphasized to doctors that her grandmother did not want to be placed on a ventilator.
Two days later, a doctor at the hospital requested the granddaughter’s consent to a do a surgical procedure on the grandmother. The granddaughter was not informed this would require intubating her grandmother and placing her on a ventilator. The surgeon was also not aware of the Advance Directive.
Two days after that, the doctor ordered the grandmother back on the ventilator when her condition continued to deteriorate. When the granddaughter confronted the doctor, he convinced her to allow him to perform a second surgery. This surgery proved unhelpful, however, as the grandmother was going into kidney failure. At this point the ventilator was removed and the grandmother was allowed to pass away, some two weeks after she was first brought to the hospital.
The granddaughter subsequently sued the hospital and the surgeon who performed the unauthorized intubation. The lawsuit alleged they “subjected the terminally ill [grandmother] to unnecessary medical procedures” in violation of her Advance Directive.
The Georgia Supreme Court was asked to settle the legal question of whether the defendants were immune from liability based on their “good faith reliance” on the granddaughter’s directions in her capacity as the grandmother’s health care agent. In a unanimous decision, the Supreme Court ruled the defendants were not entitled to such immunity. Based on the record developed so far, “the evidence would support a finding that [the surgeon] made the health care decision himself” to intubate the grandmother the second time “in the exercise of his own medical and personal judgment.” Instead, the doctor apparently acted without consulting the Advance Directive or asking the patient’s designated agent what she wanted to do.
The Supreme Court’s decision only means the defendants were not entitled to summary judgment. The Court did not address the merits of the lawsuit, which has been returned to the trial court for further proceedings.