Opinion ID: 2062379
Heading Depth: 1
Heading Rank: 3

Heading: the health care decisions act

Text: Khiem's contention that the trial court's order contravenes the HCDA need not detain us long. That statute has no bearing on the present case. The HCDA begins with the following statement: The purpose of this chapter is to affirm the right of all competent adults to control decisions relating to their own health care and to have their rights and intentions in health care matters respected and implemented by others if they become incapable of making or communicating decisions for themselves. D.C.Code § 21-2201(a) (1989). It creates a presumption of capacity, id. § 21-2203, and provides, inter alia, for certification of incapacity, id. § 21-2204; for durable powers of attorney for health care, id. § 21-2205; and for the mechanics of substituted consent, id. § 21-2210. The recitation of these provisions itself discloses that the HCDA was designed to address situations in which doctors, family members, and the courts may be required to make treatment decisions for a patient who has become unable to decide such matters for himself or herself. That this was the Council's concern becomes apparent from an examination of the Act's legislative history. The background and need for the legislation were described as follows: The law regarding decisions about life-sustaining treatment and general health-care decision-making is not clear or uniform in its application. Many of the protracted proceedings held to determine the legal propriety of decisions to forgo life-sustaining treatment have been attended by considerable publicity, compounding already tragic situations for families involved. Further, it appears that often cases only get to court if there is tremendous disagreement, if the physicians are concerned about liability, or if the family's and physician's and/or hospital's moral analysis differ. Report of the Committee on the Judiciary of the Council of the District of Columbia 2 (July 6, 1988) (emphasis added). Councilman Nathanson, who introduced the HCDA, explained that the legislation was intended to accommodate concerns regarding the authority of family members to make treatment decisions for incompetent relatives in light of the recent enactment of the guardianship law. Id. at 6. The kind of problem which the HCDA was designed to address is similar to that presented in A.C., supra . The Act established a regime under which a competent patient's wishes are followed, while in the case of an incompetent patient, a substituted judgment is made; that judgment must be based on an informed estimate of what the patient would have desired if he or she had been competent. There is not the slightest indication in the statute or in its legislative history that the Council was addressing, or entertained any view regarding, the resolution of disputes between an incompetent pretrial detainee asserting an interest in his bodily integrity and a prosecutor who has countered with the government's law enforcement interest in bringing the accused to trial. As in his discussion of our decision in A.C., Khiem focuses on the use of the word all in § 21-2201. Quoting somewhat selectively from Riggs Nat'l Bank v. District of Columbia, 581 A.2d 1229, 1235 (D.C. 1990), he argues that [i]n interpreting a statute, ... if the words are clear and unambiguous, [a court] must give effect to its plain meaning. [15] Two sentences later in the Riggs opinion, we reiterated that it is one of the surest indexes of a mature and developed jurisprudence not to make a fortress out of the dictionary. Id. at 1235 [16] (quoting Cabell v. Markham, 148 F.2d 737, 739 (2d Cir.) (emphasis added), aff'd 326 U.S. 404, 66 S.Ct. 193, 90 L.Ed. 165 (1945). Khiem's contention that the issue here presented can be resolved by resort to the Council's use of the word all exalts out-of-context literalism to undeserved preemptive pre-eminence. As Judge Learned Hand went on to note in Cabell, supra, 148 F.2d at 739, courts must remember that statutes always have some purpose or object to accomplish, whose sympathetic and imaginative discovery is the surest guide to their meaning. Accord, J. Parreco & Son v. District of Columbia Rental Hous. Comm'n, 567 A.2d 43, 46 (D.C.1989) (quoting Cabell ). Accordingly, we must identify the mischief which the legislation was designed to cure, rather than mak[ing] a fetish out of plain meaning, or wallow[ing] in literalism to defeat the legislative intent. Parreco, supra, 567 A.2d at 46. As Chief Justice Alvey stated for the court almost a century ago in Ex parte Redmond, 3 App.D.C. 317, 318 (1894), [t]aking this language literally, and without reference to the occasion and purpose of the statute, it would certainly be comprehensive enough to embrace the proposed appeal here in question. But every statute must be construed with reference to the original intent and meaning of the makers, and which intent and meaning may be collected from the cause or necessity of the enactment, and the objects intended to be accomplished by it. With the known objects and purposes of the statute in view, general language may and should be restricted to the accomplishment of such objects and purposes, and not be made to embrace objects not contemplated by the authors of the statute. This is an old and well settled canon of construction. Times have changed, but the canon survives; this passage might well have been written with the present case in mind. Finally, if we were to interpret the HCDA as Khiem proposes, that statute would be effecting a partial implicit repeal of § 24-301(a). Under the terms of the earlier statute, a committed patient in Khiem's circumstances is protected only from arbitrary and capricious treatment decisions of hospital officials, and does not have the kind of unfettered decision-making authority over his treatment contemplated by the HCDA. See Part II B, supra. Repeals by implication are not favored, and this canon must be taken seriously; mere lip service to it would leave legislators in a perpetual state of uncertainty about the possibility that every new enactment may have unintended consequences. Speyer v. Barry, 588 A.2d 1147, 1165-66 (D.C.1991); see also United States v. Hansen, 249 U.S.App.D.C. 22, 26, 772 F.2d 940, 944 (1985) (Scalia, J.), cert. denied, 475 U.S. 1045, 106 S.Ct. 1262, 89 L.Ed.2d 571 (1986).