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Monday, January 14, 2013

Ind. Courts - "End-of-life case splits family"

Yesterday and today Tim Evans of the Indianapolis Star has featured an end-of-life battle involving Paul G. Smith of Carmel, a retired attorney and former Hamilton County court magistrate. He is hospitalized at St. Vincent's.

Here is yesterday's lengthy story. A few quotes:

[T]he responses and requests uttered by the gravely ill Smith from his bed at St. Vincent Hospital carry little weight.

That's because hospital officials are following directives in a living will Smith signed nearly a decade ago. It restricts actions medical providers can take to keep him alive and hands decisions about artificially supplied nutrients and fluids to another daughter, Judith Sly.

Last week, doctors removed Smith from the ventilator that helped ease his labored breathing, apparently acting in accordance with the living will and Sly. Hospital staff occasionally moisten Smith's lips with a damp sponge, but a feeding tube that once provided nourishment also was disconnected.

Those moves infuriate [his daughter Susan] Rissman, exacerbating a long-standing family divide that has only deepened since Smith, whose condition deteriorated rapidly, was hospitalized in December with dehydration.

Even though Smith's attorney tried unsuccessfully in November to name Rissman her father's legal guardian, Sly has authority over his care and legal affairs. And her decisions, according to court records, appear to be backed by another sister and a brother.

Rissman has been her father's primary caregiver for the past several years and is against stopping an active treatment regimen for him. She thinks any decision should be left up to Smith because he is able to talk and answer questions.

It is a sad and controversial end for the retired attorney and former Hamilton County court magistrate who is at the middle of a family's fight over control of his care and, ultimately, a significant estate that includes investments and a home in Carmel valued at $241,000.

But the saga underscores broader issues: The importance of keeping health care plans up-to-date, medical ethics and the gut-wrenching dynamics of end-of-life decisions.

Today's story is headed "Daughter seeks hearing in Carmel attorney's end-of-life directives." It begins:
A fight over the medical treatment of a gravely ill 88-year-old man at St. Vincent Indianapolis Hospital was expected to land back in court today, according to a Hamilton County attorney who said he plans to ask a judge to review the condition and care of Paul G. Smith.

Tim Stoesz said he would file an emergency request in Hamilton Superior Court this morning on behalf of Smith's daughter, Susan Rissman, in an effort to learn why hospital staff are following a living will's end-of-life directives cutting off artificially supplied nutrients and fluids to the Carmel man. Smith is conscious and aware, Stoesz said, and the attorney said he believes Smith wants to control his care, rather than have decisions be made by another daughter who has power-of-attorney rights over him.

The Star also provides links to four documents:

Posted by Marcia Oddi on January 14, 2013 08:33 AM
Posted to Indiana Courts