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Published on: February 16, 2011
The Barnes case: taking difficult futility cases public.
Ruth A Mickelsen1, Daniel S Bernstein, Mary Faith Marshall
1Center for Bioethics, School of Public Health, University of Minnesota.
Summary
Courts are increasingly involved in resolving medical futility disputes, especially when surrogates demand aggressive treatments. A case study shows how the judicial system can help replace unfaithful surrogates and guide end-of-life care discussions.
Area of Science:
- Medical Ethics
- Healthcare Law
- Bioethics
Background:
- Medical futility disputes are rising, challenging historical judicial reluctance to intervene.
- Surrogate demands for aggressive treatment in futile cases create complex ethical and legal dilemmas.
- Lack of legislative guidance places the burden of resolving these disputes on clinicians and institutions.
Purpose of the Study:
- To analyze the trend of judicial involvement in medical futility disputes.
- To examine the responsibilities of clinicians and hospital administrators in such cases.
- To illustrate how the legal system can resolve surrogate conflicts and guide end-of-life care.
Main Methods:
- Case study analysis of 'In re Emergency Guardianship of Albert Barnes'.
- Review of legal and ethical considerations in medical futility disputes.
- Examination of institutional resource commitment and media management in litigation.
Main Results:
- The judicial system is becoming a more common venue for resolving medical futility disputes.
- Litigation necessitates significant institutional resources, media management, and courage.
- The Barnes case demonstrated successful judicial intervention to replace a surrogate and cease inappropriate care.
Conclusions:
- Courts are increasingly engaging in medical futility disputes, moving beyond historical reluctance.
- Institutions must navigate complex ethical, legal, and media challenges when using the judicial system.
- The Barnes case provides a model for resolving surrogate conflicts and promoting end-of-life care dialogue.
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