Court Opinion

ID: 9628473
Source: CourtListenerOpinion
Date Created: 2023-08-22 09:21:47.898201+00
Date Added: 2024-06-11T18:07:06.083810
License: Public Domain

Rosellini, J.
(dissenting) — The majority departs dramatically from the issues presented in this case, and needlessly resolves questions not before it. Because I believe the court's discussion of court intervention is both unnecessary and unwise, I dissent.
The unnecessary nature of the majority's discussion is obvious. As the majority observes, Joseph Hamlin "had no *825family, relatives or close friends with which the medical staff could consult concerning his treatment." Majority opinion, at 813. Decisions regarding his treatment were developed by the medical staff and offered to an appointed guardian for approval. The guardian, believing it was without authority, disapproved. This appeal then arose. The case presented essentially one issue to the court. That issue involved only who had authority to consent to termination of life support systems.
The majority, after properly resolving this issue, then seizes the opportunity to discuss generally the necessity of guardianship proceedings and court intervention. The majority concludes that if the patient's medical prognosis board and the family all agree, neither a court appointed guardian or court intervention is required. Where the patient has no family, the majority allows these decisions to be made by the guardian and the medical staff.
The majority adopts this position without exploring the ramifications of its rule or the wisdom of waiving court intervention. Closer analysis of these issues, I believe, demonstrates the dangers of a court attempting to resolve so complex a problem with such simple rules.
First, the majority's decision to circumvent court appointed guardian proceedings negates the safeguards inherent in the guardian statutes and authorizes, illegally, a person other than the patient to exercise the patient's right to refuse treatment. In re Colyer, 99 Wn.2d 114, 660 P.2d 738 (1983) established that the right to refuse treatment is a corollary of the constitutional right to privacy and the common law right to be free from bodily invasion. Colyer, at 121. This right, however, is personal to the patient. Only the guardian statute, RCW 11.92.010, contains an acknowledged mechanism for transferring the privilege of exercising this right to someone other than the patient. Nowhere does the majority explain its authority to ignore the legislative scheme in favor of a de facto guardianship by the family. Absent patient consent, no such authority exists.
Moreover, competency is a legal determination which *826must be made by a court. The majority's decision to forgo guardianship proceedings delegates the judicial responsibility to determine a legal status to the medical profession and the family.
The majority's decision to waive the guardianship proceeding is also unwise in that it removes important safeguards to the decisionmaking process. Without a guardianship proceeding, the decision to terminate life support systems may be made by family members who have improper motives or whose views do not reflect those of the patient. Furthermore, neither the fact that all family members need to agree nor the concurrence of the medical prognosis board adequately protects against this eventuality. Where family members all stand to benefit by termination, they would naturally agree and present a unified front.
Moreover, medical professionals cannot guard against improper motives on the part of the family because they are neither suited by training nor situation to discover such impropriety. Doctors are trained to discover and treat disease and trauma, not to discern the truth of factual assertions. Also, a doctor may not, without significant impertinence, inquire as to the family members' financial relationships to the patient. In fact, a doctor may not be able to even ascertain if all family members have been consulted or even notified of the event. Distant siblings or offspring may be omitted from the decisionmaking process until it is too late for the decision to be reversed.
The majority's opinion ignores these dangers; I cannot.
On the other hand, I am not unsympathetic to the majority's desire to mitigate the legal formalities a grieving family must confront. Alternatives to the all or nothing rule propounded by the majority exist, however. For instance, in cases where family members can demonstrate the patient's intent to vest them with authority to act in this manner, guardianship proceedings might be unnecessary. Such manifestation could be more informal than the Natural Death Act documents but still vested with some safeguards. A *827patient's informal consent to the doctor, witnessed by one of his staff, might be sufficient.
I believe the medical profession, the Legislature and the courts must pursue all available alternatives with full knowledge of each solution's implication. Because the majority attempts to resolve these issues without a proper case before it, I dissent.
Dore, J., concurs with Rosellini, J.