Senin, 07 Juni 2010

What Gary Coleman Case Teaches about Surrogate Decision Making



After Gary Coleman was admitted to the Utah Valley Regional Medical Center, his medical decisions were made by Shannon Price.  The hospital looked to her as his wife.  But Coleman and Price had divorced back in August 2008.  So, the question being asked was: "Should the hospital have looked to Price as Coleman's surrogate decision maker?"  (LA Times)


Coleman had an advance directive appointing Price as his healthcare agent.  Therefore, there is no need to turn to Utah's default decision making laws.  Instead, to determine whether the hospital did the right thing, we must look to Utah's advance directive statute.  The first step of the analysis is to determine whether the divorce constituted a revocation of the advance directive.  Utah Code 75-2a-1113(1)(f) provides that "By a decree of annulment, divorce, dissolution of marriage, or legal separation that revokes the designation of a spouse as an agent, unless: (i) otherwise specified in the decree; or (ii) the declarant has affirmed the intent to retain the agent subsequent to the annulment, divorce, or legal separation."  


In short, divorce does undo the agency of an ex-wife, unless the principal specifically wants to retain the ex-wife as agent.  Did Coleman express any such desire?  He was still living with Price.  Is that enough?  Was the advance directive completed after the date of the divorce?  If so, that would probably be enough.  There are not sufficient publicly available facts to determine whether there was a revocation.  But we can complete out analysis without answering the revocation question. 


Whatever the outcome of the first step of the analysis, the second step is dispositive.  Utah Code 75-2a-1114 provides that the facility can look to Price so long as it has a "good faith belief" that Price has the authority she asserts.  So, at the implementation stage, actual authority does not matter as much as apparent authority.  Price said she was Coleman's wife.  She appeared to be Coleman's wife.  With no reason to doubt Price, the Utah hospital (as with hospitals everywhere) was entitled to trust her representations.


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