No ‘Heroic’ Treatments for Patient, Judge Orders

In the latest of a series of court cases focusing on a patient’s right to die, a Reseda nursing home Tuesday was ordered not to use “heroic” medical means to sustain the life of a 75-year-old man suffering from Alzheimer’s disease, an irreversible deterioration of the brain.

Citing requests set down in a “living will” signed by the patient, Jacob Jack Cantor, while he was mentally sound, Los Angeles Superior Court Judge Jack M. Newman issued a temporary restraining order prohibiting the Convalescent Center of Reseda from acting to prolong Cantor’s life or transfer him to another health-care facility for such treatment.

The restraining order, sought by Lydia Cantor, the patient’s former wife and current legal guardian, also temporarily prohibits state or local agencies from prosecuting the nursing home for failing to provide care for Cantor.

Lydia Cantor, 66, a retired secretary from Sherman Oaks, said her ex-husband began developing symptoms of Alzheimer’s disease in 1981. At the time, he signed a “living will” in which he said that certain medical treatments were “abhorrent” to him--particularly mechanical ventilators or feeding tubes. If he fell victim to an incurable mental or medical condition, Jacob Cantor said, he wished to die without such intervention.

Condition Has Deteriorated

Three years ago, he was admitted to Convalescent Center of Reseda, where his condition continued to deteriorate, Lydia Cantor said.

Although they were divorced in 1984, she said she visits her ex-husband every other day. She described him as glassy-eyed, unable to walk or feed himself, incontinent and unresponsive.

Lydia Cantor decided to sue, she said, after the nursing home last month sent him to a nearby hospital for treatment of pneumonia without her consent. She feared that, without a court order, the nursing home would continue to treat him against his wishes and without her consent, she said.

A patient’s “right to die” first became a prominent issue 10 years ago with the case of Karen Ann Quinlan, a comatose New Jersey woman, and has continued to confront the courts and medical establishment in a series of highly publicized cases, including that of Elizabeth Bouvia, a 28-year-old quadriplegic who sued a Riverside hospital for the right to starve herself to death.

Lydia Cantor’s attorney, Richard Scott, a noted advocate of patients’ rights, said Jacob Cantor will soon lose the ability to swallow, and Lydia Cantor fears that the nursing home then will use a feeding tube to sustain his life, a “heroic” measure that the patient specifically requested not be used.

Under California law, an individual can refuse life-prolonging medical care or appoint a substitute decision maker if the individual becomes incapable of making such decisions. California is one of 39 states that recognizes a living will as a legal document, according to Gay Ingvordsen, assistant director of Concern for the Dying, a New York-based organization.

Judge Newman put off until Dec. 4 any decision on a permanent injunction against life-prolonging medical treatments for the patient.

Neither Jacob Cantor’s physician nor the nursing home administrator was present at the hearing or available for comment Tuesday.

Although there was some debate over the wording of the order, the home’s attorney did not fight Lydia Cantor’s motion.

“These cases are not about killing,” said Scott, who recently represented a dying patient in an El Monte nursing home. “They involve the patients right to say no to medical treatments.”

He said that nursing homes are “paralyzed” by a fear of fines or criminal prosecution if they accede to a patient’s request to die.

Jay N. Hartz, attorney for Convalescent Center of Reseda, agreed. “There is a perception in the nursing home industry that the Department of Health will assess fines if care is not provided,” he said.

Lydia Cantor said she understands that health care providers “have to protect themselves legally,” she said.

But her ex-husband’s rights come first, she said. “I know what Jack wants. He’s said to two doctors, ‘I don’t want to live like this.’ ”