Can operation be done for Mom if she's not coherent to consent?

[Subjection]

What is the name of your state (only U.S. law)? IL

Here's the current situation (which I was just told about minutes ago). My Mom is in the hospital 600 miles away and has almost total blockage of all 4 arteries to her heart and will die without open heart surgery. My brother is with her and called me about the situation. He says that she is under a lot of drugs including Morphine, so she can't understand what's going on or give consent to the surgery, in which case she will die. I kept suggesting things like having my brother take on power of attorney in order to give consent for her, but he says he can't do that.

So, from a legal standpoint, what CAN be done? It doesn't seem right that a person who needs an operation to save their life has to be allowed to die simply because they are too drugged up to understand what's going on. A person found unresponsive after a car accident certainly wouldn't be allowed to die just because they weren't conscious to give consent for life-saving measures to be done.

Any ideas?

 

[Proserpina]

What is the name of your state (only U.S. law)? IL

Here's the current situation (which I was just told about minutes ago). My Mom is in the hospital 600 miles away and has almost total blockage of all 4 arteries to her heart and will die without open heart surgery. My brother is with her and called me about the situation. He says that she is under a lot of drugs including Morphine, so she can't understand what's going on or give consent to the surgery, in which case she will die. I kept suggesting things like having my brother take on power of attorney in order to give consent for her, but he says he can't do that.

So, from a legal standpoint, what CAN be done? It doesn't seem right that a person who needs an operation to save their life has to be allowed to die simply because they are too drugged up to understand what's going on. A person found unresponsive after a car accident certainly wouldn't be allowed to die just because they weren't conscious to give consent for life-saving measures to be done.

Any ideas?

Life-saving measures to stabilize a patient are one thing and do not require consent. This isn't to stabilize her - she's technically already stable.

Who is her next of kin?

 

[Subjection]

Life-saving measures to stabilize a patient are one thing and do not require consent. This isn't to stabilize her - she's technically already stable.

Who is her next of kin?

I guess that would be me and my one brother. So I thought for sure my brother would be able (legally) to make the decision for her when she's incompetent. Is there anything my brother can do? He's right there with her while I'm 600 miles away.

 

[justalayman]

Has anybody spoken to the hospital administration? They will be able to assist you on whether your mother can consent in her condition and if not, if her medication can be altered to allow a moment of lucidity so that she can give or deny consent.

If she is unable to consent due to mental issues there may need to be a guardian appointed by the courts who can then give or deny consent.


A POA cannot be granted by your mother if she is mentally incapacitated which is why your brother cannot "take on" a POA without a court order.

 

[FlyingRon]

I guess that would be me and my one brother. So I thought for sure my brother would be able (legally) to make the decision for her when she's incompetent. Is there anything my brother can do? He's right there with her while I'm 600 miles away.

I presume there's no living will or health care power of attorney document in place. Illinois law allows the adult child of the incapacitated person to be considered the surrogate decision maker for most of the decisions provided they do it along the lines of what the patient would have wanted. He should make himself known as such to the treating doctor. It would help if you provided a letter that you support his decision (when there are multiple potential surrogates at the same level as you are, there's supposed to be consensus).

 

[Subjection]

Has anybody spoken to the hospital administration? They will be able to assist you on whether your mother can consent in her condition and if not, if her medication can be altered to allow a moment of lucidity so that she can give or deny consent.

If she is unable to consent due to mental issues there may need to be a guardian appointed by the courts who can then give or deny consent.


A POA cannot be granted by your mother if she is mentally incapacitated which is why your brother cannot "take on" a POA without a court order.

I actually suggested this when I was on the phone with my brother's friend at the hospital. She said that if they reduce the pain medication, she might become more able to make a decision, but also be in more pain and therefore not be as likely to want to go through with the operation. I'm not sure how they came to that conclusion. Tomorrow morning is the next time a doctor will be available for her to give consent.

 

[Subjection]

I presume there's no living will or health care power of attorney document in place. Illinois law allows the adult child of the incapacitated person to be considered the surrogate decision maker for most of the decisions provided they do it along the lines of what the patient would have wanted. He should make himself known as such to the treating doctor. It would help if you provided a letter that you support his decision (when there are multiple potential surrogates at the same level as you are, there's supposed to be consensus).

I don't know of any will that was made. There probably isn't any. The problem seems to be that she's not completely incapacitated, but rather is under the influence of so many drugs they have her on. They put me on the phone with her briefly and I don't think she knew who she was talking to. She didn't say anything that made any sense. I'm told that as long as she's conscious, she has to make her own decisions. Only if she was completely incapacitated could my brother do it. Awake and drugged up is apparently "able to make sound decisions" in the eyes of the hospital. Does the law agree?

 

[FlyingRon]

If her conditions make it impossible for her to express consent, yes the law applies. If the hospital is asking you or the brother, they've already made that determination. You two must make the call.

 

[Subjection]

If her conditions make it impossible for her to express consent, yes the law applies. If the hospital is asking you or the brother, they've already made that determination. You two must make the call.

Thank you.
Well, by what my brother has told me today, she is awake but it's hard to say she's coherent. She's refusing the operation, so it looks like the decision has been made by her already. But my brother says doctors have been asking him for consent about pretty much everything else for some reason, and even that they may have to call me for permission as well. They don't need permission from all siblings for every step of treatment, do they? I thought only one person was needed to be a "consent giver".

 

[LdiJ]

Thank you.
Well, by what my brother has told me today, she is awake but it's hard to say she's coherent. She's refusing the operation, so it looks like the decision has been made by her already. But my brother says doctors have been asking him for consent about pretty much everything else for some reason, and even that they may have to call me for permission as well. They don't need permission from all siblings for every step of treatment, do they? I thought only one person was needed to be a "consent giver".

If they are going to try to override your mother's expressed wishes on the basis that she is not coherent enough to make that decision, they are going to err on the side of caution and make sure that all of her children are on the same page.

 

[Subjection]

If they are going to try to override your mother's expressed wishes on the basis that she is not coherent enough to make that decision, they are going to err on the side of caution and make sure that all of her children are on the same page.

Yes, in fact that's exactly what they did yesterday. I got a call from a nurse at the hospital asking me if I would consent to my brother being the surrogate decision maker. Of course I said yes, to which she replied that they can go forward with the paperwork to make that happen. My brother and I are the only offspring of my mom, so I was the only other person that needed to be asked. But now my brother tells me that she's apparently in such bad shape that nobody wants to do the operation for fear that she'd die during the operation. I guess now they are looking for a nursing home for her to stay at. Not sure how that gets paid for. I've heard it costs everything the patient has, but I guess I'll need to do some research on that.

 

[LdiJ]

Yes, in fact that's exactly what they did yesterday. I got a call from a nurse at the hospital asking me if I would consent to my brother being the surrogate decision maker. Of course I said yes, to which she replied that they can go forward with the paperwork to make that happen. My brother and I are the only offspring of my mom, so I was the only other person that needed to be asked. But now my brother tells me that she's apparently in such bad shape that nobody wants to do the operation for fear that she'd die during the operation. I guess now they are looking for a nursing home for her to stay at. Not sure how that gets paid for. I've heard it costs everything the patient has, but I guess I'll need to do some research on that.

I find this disturbing. How old is your mother and does she have health insurance? Based on what you described previously your mother is going to die if she does not get the surgery.

 

[Gail in Georgia]

How about getting yourself over to that hospital and sitting down with the medical team to find out exactly what the status is with your mother. If she is too unstable to undergo bypass surgery and needs to be placed on a situation such as a nursing home you can request a discussion with a social worker in the hospital to determine the costs of such.

Getting information second hand from a relative is often confusing and sometimes inaccurate.

Gail

 

[Subjection]

How about getting yourself over to that hospital and sitting down with the medical team to find out exactly what the status is with your mother. If she is too unstable to undergo bypass surgery and needs to be placed on a situation such as a nursing home you can request a discussion with a social worker in the hospital to determine the costs of such.

Getting information second hand from a relative is often confusing and sometimes inaccurate.

Gail

The hospital was over 600 miles away. But it's too late now. My brother took care of everything. She went to a nursing home and died after 12 hours there and now my brother got a statement saying they are charging for 31 days. Also, after the funeral (3 weeks ago) they told my brother that my Mom's $8,000 burial plan doesn't even cover the burial vault or obituaries. Now he's on the hook for nearly a thousand dollars and wants me to pay half. So much for burial plans covering everything as advertised....