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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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.

The Journal of Law, Medicine & Ethics : a Journal of the American Society of Law, Medicine & Ethics

|April 16, 2013

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.

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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.