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New Jersey's “Granny Doe” Squad: Arguments about Mechanisms for Protection of Vulnerable Patients

Published online by Cambridge University Press:  29 April 2021

David M. Price  and
Paul W. Armstrong
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Extract

A decision not to hospitalize, dialyze or resuscitate a dying, elderly, nursing home resident is regarded as “possible abuse.” Any physician, nurse, administrator, social worker, aide or other staff member who learns of plans to withhold treatment is required to report this fact to a state official. That official will conduct an investigation “to determine whether the legal guidelines...are satisfied.” While the often protracted investigation is pending, “the facility itself (must) preserve the patient's health.”

A letter declaring this to be the requirement of current New Jersey law was recently sent to administrators of all nursing homes and psychiatric hospitals by the state's Office of the Ombudsman for the Institutionalized Elderly.

The policy has provoked strong protests from health professional organizations and advocates for the privacy of patients and families. Alert clinicians are reportedly maneuvering to place their patients beyond the Ombudsman's reach.

Type
Article
Information
Law, Medicine and Healthcare , Volume 17 , Issue 3 , Fall 1989 , pp. 255 - 263
Copyright
Copyright © American Society of Law, Medicine and Ethics 1989

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References

Letter addressed to New Jersey long-term care facilities by Hector M. Rodriguez, dated August 30, 1988.Google Scholar
American Academy of Pediatrics v. Heckler, 561 F. Supp. 395 (D.C. 1983). Here the court ruled that the Secretary of Health and Human Services had failed to follow proper procedures (Administrative Procedure Act) in promulgating the so called “Baby Doe” regulations.Google Scholar
N.J.S.A. 52:27G1 et seq. The authors wish to point out that on occasions the Ombudsman has sought to legislatively extend the office's jurisdiction to acute hospitals.Google Scholar
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In re Farrell, 108 N.J. 335, 529 A.2d 404 (1987). Kathleen Farrell was a competent, 37 year old, terminally ill patient with amyotrophic lateral sclerosis (ALS) being cared for at home. Her husband, in keeping with her decision, requested an appointment as her special medical guardian with express permission to remove his wife's respirator. The court held that as long as two doctors concurred in her competence and prognosis, no court intervention was necessary to honor her decision to remove the mechanism. (Mrs. Farrell died during the pendency of the appeal to the New Jersey Supreme Court).Google Scholar
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