Once a Guardian, Always a Guardian

Right? ??

Rosemary Flanigan
April 14, 2009

I told you that last week I had used the recent Hastings Center Report case with my ethics brown bag session. The case involved a fifty-nine-year-old male who was being readmitted to the hospital from a nursing home because he has gangrene of three right toes and both his heels.

He is being told that amputation is necessary: the right leg above the knee and the left heel. What does he say? “Let’s wait it out.” And his family concurs.

Well, of course, the doctors wondered at his capacity, and voila! didn’t they discover that nine years ago, the family chose not to be his legal guardian so he was appointed one. So shouldn’t the team contact the guardian?

Though we have no information about his condition during the intervening years, I was dead set against re-activating the guardian. But 2/3 of the brown baggers took it for granted that the guardian needed to be consulted. They said, “Once you have a guardian, you have a guardian unless the court revokes it.”

But I caught dear Bill Colby on the fly this morning and he said a case can be made either way.

I think my problem is: Those in the majority seemed so implacable; they had found “an answer” in the law, and someone “outside” was going to make a decision about this “waiting” option.

It was an “ethics” brown bag, and I would have hoped that the providers would have talked more to the poor patient to try to understand his “Let’s wait.” But, like so many arguments, if you think you have “the answer,” why bother with all the loosey-goosey in-between matter?

You must have experienced this in YOUR healthcare lives; isn’t it frustrating?? HELP!