Hospital Seeks Right to Transfer Certain Terminally Ill Patients

Glendale Adventist Medical Center spokesmen said Wednesday they will ask the 2nd District Court of Appeal to allow private hospitals to transfer “ambivalent” terminally ill patients to state or county institutions if life-support systems are to be cut off.

The court late last month expanded the right of dying patients to refuse “heroic” medical treatments to prolong their lives, deciding that they need not be in a “comatose, vegetative state” to have artificial life-support systems disconnected. The justices ruled in a civil suit brought by the late William F. Bartling, 70, who died a day before the appellate court heard arguments last Nov. 7.

Bartling, who remained conscious despite suffering from five potentially fatal diseases, claimed that he had a right to decide to pull the plug, even though his doctors objected. Medical center personnel countered that Bartling vacillated between wanting to die and to live, that his illnesses were not necessarily terminal and that treatment might “wean” him from the respirator.

Los Angeles Superior Court Judge Lawrence Waddington had relied on California’s Natural Death Law and existing case law in noting that medical support systems should be removed only for unconscious patients with terminal diseases when doctors approved.

In overruling Waddington and deciding that conscious, coherent terminally ill patients also have a right to die, the appellate panel held that doctors who follow those patients’ decisions to pull the plug are free of criminal and civil liability.

“Our doctors and the administration were not altogether displeased with the decision as applied to the broad case,” Glendale Adventist Medical Center spokesman Jim Gallagher said. “It does provide some guidelines and removes the criminal and civil liability from doctors. We disconnect life-support systems here all the time when it is clear that is what the patient really wants and the doctors and family agree.”

He added, however, that the medical center remains concerned about the ethics of disconnecting life-support systems when patients are ambivalent--as doctors believe Bartling was--about living.

“So instead of appealing the decision to the Supreme Court, we are going back to the state Court of Appeal to get a clarification from them that we think will accomplish what we need done,” Gallagher said. “That is, to give doctors and the hospital more rights in carrying out their ethical and medical judgments. If in a single case the court were to order removal of life support where there is some ambivalence, we could effect a transfer to a county or state institution.”

Had Bartling lived, under the appellate ruling doctors at Glendale Adventist Medical Center would have been obligated to disconnect his respirator even though they considered such action improper ethically and medically.

Permitting private hospitals to transfer such patients to public institutions, Gallagher indicated, would place responsibility for carrying out court orders on government-paid personnel.