Problem: PHYSICIAN AND ADMINISTRATOR FILE FOR TEMPORARY GUARDIANSHIP
The court in In re Estate of Dorone granted temporary guardianship. In this case, the physician and administrator petitioned the court on two occasions for authority to administer blood. A 22-year-old male patient brought to the Hospital Center by helicopter after an automobile accident was diagnosed as suffering from an acute subdural hematoma with a brain contusion. It was determined that the patient would die unless he underwent a cranial operation. The operation required the administration of blood, to which the parents would not consent because of their religious beliefs. After a hearing by telephone, the court of common pleas appointed the hospital's administrator as temporary guardian, authorizing him to consent to the performance of blood transfusions during emergency surgery.
A more formal hearing did not take place because of the emergency situation that existed. Surgery was required a second time to remove a blood clot, and the court once again granted the administrator authority to authorize administration of blood. The superior court affirmed the orders, and the parents appealed. The Pennsylvania Supreme Court held that the judge's failure to obtain direct testimony from the patient's parents and others concerning the patient's religious beliefs were not in error when death was likely to result from withholding blood. The judge's decisions granting guardianship and the authority to consent to the administration of blood were considered absolutely necessary in the light of the facts of this case. Nothing less than a fully conscious contemporary decision by the patient himself would have been sufficient to override the evidence of medical necessity.
Ethical and Legal Issues
1. Can a hospital act to save a patient's life if he or she has not given written consent to a procedure?
2. What types of monetary awards should the court give the plaintiff, if any? Why?