New Case - Wheelock v. Doers (Tenn. App. 2010)

This week, the Tennessee Court of Appeals issued its opinion in Wheelock v. Doers.  Basically, providers allegedly both wrote a DNR order and then later refused to perform CPR even at the specific and vocal instruction of the family and appointed agent.  It is a factually complicated case, with questions of causation and advance directive authority.  But at the trial level, the judge was squarely looking at the medical futility questions.

• We have had a great deal of discussion here about medical services and the request of medical care providers as to whether there can be a cause of action for not providing medical services that a health care provider finds are not within those services required to be given under the standard of care, but at this point I don't believe the law of this state allows a patient or others to bring an action against a health care provider for not providing services that, within the standard of care, would not have been provided.


• And the classic, the easiest example I can think of it, we talked about something specific in this case, but I think we're going to get away from it, so the issue is clearly identified. A patient walks in and says I want a full-body MRI to find out if I have got cancer anywhere. And a health care provider, it could be one of several different types, under the standard of care is not required and will not order that service because that's not required of the standard of care.


• Can that health care provider then be sued for not providing the service requested of them that is available and can be given, but is not necessary under the standard of care? I think the answer at this point is no. And there is a lot of reasons-you can say no and yes in regard to that question, but I think at present there has been no indication that there is a cause of action for that in Tennessee.


• Just because a patient says I want it, does that mean you have to give it and continue giving it to when? But those are the reasons why it is left to the standard of care in the health-care industry, be it the nurses' standard of care or the doctors,' the reason why that's left to that decision.