Case Scenario: ETHICS COMMITTEE SERVES AS GUARDIAN

The Kentucky Supreme Court ruled in Woods v. Commonwealth, 1999-SSC0773 (August 24, 2004) that Kentucky's Living Will Directive, allowing a court-appointed guardian or other designated surrogate to remove a patient's life support systems, is constitutional. The patient in this case, Woods, had been placed on a ventilator after having a heart attack. It was generally agreed that he would never regain consciousness and would die in 2 to 10 years. After a recommendation of the hospital ethics committee, Woods's guardian at the time asked for approval to remove Woods's life support. The Kentucky Supreme Court affirmed an appeals court decision, holding that: (1) "If there is no guardian," but the family, physicians, and ethics committee all agree with the surrogate, there is no need to appoint a guardian; (2) "If there is a guardian" and all parties agree, there is no need for judicial approval; (3) "If there is disagreement," the parties may petition the courts. Withdrawal of life support from a patient is prohibited absent clear and convincing evidence that the patient is permanently unconscious or in a persistent vegetative state and that withdrawing life-support is in the patient's best interest.

Ethical and Legal Issues

1. Discuss the ethical issues of this case.

2. Discuss under what circumstances an ethics committee should serve as a legal guardian.

3. Discuss the pros and cons of an ethics committee serving as a patient's guardian.