Reading Hospital Resolves Futility Dispute by Replacing Guardian

In March 2012, Russell Border was admitted to the ICU at Reading Hospital and Medical Center. As a patient in the ICU, doctors placed Mr. Border on a mechanical ventilator and other forms of life-sustaining treatment. During this time, Mr. Border's treating physician and other Hospital personnel contacted his court-appointed guardian, Sharon Gray, explaining that Mr. Border's health condition was both terminal and futile.  (The court's recitation of the medical testimony is appropriately both extensive and graphic.)

Hospital personnel recommended that, as guardian of his person, Gray authorize the removal of Mr. Border's life-support. Mr. Border's family, including his wife, brother, sister, sister-in-law, and both adult daughters, all agreed with the Hospital's recommendation. Gray, however, disagreed and asserted her authority as guardian of Mr. Border's person to prohibit the removal of his life-support.  

Unable to resolve the conflict, the Hospital filed a petition with the Berks County, Pa. Court of Common Pleas, seeking the removal of Gray as Mr. Border's guardian.  The court granted the petition and replaced the guardian.  This order was affirmed last week by the Superior Court of Pennsylvania.  (The new guardian immediately consented to the removal of life support and Mr. Border died the same day.)

Notably, Border's advance directive indicated that he would want life-sustaining treatment in his current condition.  So, Gray felt that she was being a faithful and diligent guardian by demanding that treatment.  But Border also indicated that his elections were to serve only as a "general guide" and could be altered if alteration was in his best interest.  

The court held that alteration was in Border's best interest.  Consequently, by refusing to authorize the termination of Border's life-sustaining treatment, Gray ceased acting in his best interest.  The appointment of a new guardian was appropriate.  I have been defending (and here) surrogate replacement as a mechanism for resolving futility conflicts.  This case is a good example.